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Organization

GEHRED FAMILY DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CORNELIUS GEHRED DDS (PRESIDENT)
(503) 254-2068
Entity
Organization

Contact information

Practice address
10340 SE DIVISION ST, SUITE 1, PORTLAND, OR 97266-1269
(503) 254-2068
(503) 252-5820
Mailing address
10340 SE DIVISION ST, SUITE 1, PORTLAND, OR 97266-1269
(503) 254-2068
(503) 252-5820

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
D4833
OR
122300000X
Dentist
D8874
OR
122300000X
Dentist
Primary
D9242
OR

Other

Enumeration date
09/23/2010
Last updated
09/23/2010
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