Individual
LAWRENCE PAUL GAGNON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1904 NE 45TH AVE, PORTLAND, OR 97213-1418
(503) 281-0866
(503) 281-0867
Mailing address
1904 NE 45TH AVE, PORTLAND, OR 97213-1418
(503) 281-0866
(503) 281-0867
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4825
OR
Other
Enumeration date
07/18/2005
Last updated
07/08/2007
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