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General NPI Number Information
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NPI Number | 1407092471
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Entity Type | Individual
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Provider Name | CURTIS EDWARD GREGOIRE DDS, MD
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Gender | Male
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 12/22/2008
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Provider Practice Location Address
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Address Line | 2801 N GANTENBEIN AVE
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City | PORTLAND
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State | OR
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Zip | 97227-1623
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Country | US
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Telephone | 503-849-1661
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Fax |
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Provider Business Mailing Address
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Address Line | 1749 SW PARKVIEW CT
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City | PORTLAND
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State | OR
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Zip | 97221-2639
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Country | US
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Telephone | 503-954-3127
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | LL17506
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License Number State | OR
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