Individual
DR. JERRY ALLEN RENSCH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4707 NE TILLAMOOK ST, PORTLAND, OR 97213-2057
(502) 287-9710
(503) 281-7098
Mailing address
4707 NE TILLAMOOK ST, PORTLAND, OR 97213-2057
(502) 287-9710
(503) 281-7098
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4266
OR
Other
Enumeration date
07/05/2005
Last updated
07/08/2007
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