Individual
DR. SAMUEL GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
17675 SW TUALATIN VALLEY HWY, BEAVERTON, OR 97006-4443
(503) 259-3160
Mailing address
12401 SHELBY CT, LAKE OSWEGO, OR 97035-1102
(503) 245-0384
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D7245
OR
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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