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Individual

DR. GORDON RODNEY STANGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
200 GWEE SHUT RD, SILETZ, OR 97380-2036
(541) 444-1030
Mailing address
PO BOX 320, SILETZ, OR 97380-0320
(541) 444-1030

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9685
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500662095
OR
Enumeration date
11/20/2011
Last updated
02/22/2017
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