Individual
EUGENE OWEN KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
611 SW CAMPUS DR, PORTLAND, OR 97239-3001
(503) 494-0292
(503) 494-0294
Mailing address
611 SW CAMPUS DR, PORTLAND, OR 97239-3001
(503) 494-0292
(503) 494-0294
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D3452
OR
Other
Enumeration date
03/06/2009
Last updated
03/06/2009
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