Individual
GREGORY THOMAS GOODLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
11769 NE GLISON ST, PORTLAND, OR 97220
(503) 252-9901
(503) 252-3094
Mailing address
11769 NE GLISAN ST, PORTLAND, OR 97220
(503) 252-9901
(503) 252-3094
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7070
OR
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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