Individual
DR. STANLEY WALTER BOHNSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
15012 SE STARK ST, PORTLAND, OR 97233-2854
(503) 255-9339
(503) 255-9375
Mailing address
PO BOX 33226, PORTLAND, OR 97292-3226
(503) 255-9339
(503) 255-9375
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6260
OR
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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