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Jacy A. Stauffer, DMD
Pediatric Dentist in Portland, Oregon
NPI 1699974014

Jacy A. Stauffer is a Pediatric Dentist based in Portland, OR and is specialized in Pediatric Dentistry. Jacy A. Stauffer practices in Portland, OR and has the professional credentials of DMD. The NPI Number for Jacy A. Stauffer is 1699974014 and holds a License No. LL738 (Oregon).

The current practice location address for Jacy A. Stauffer is 3181 Sw Sam Jackson Park Rd, Portland, OR and can be reached out via phone at 503-418-5799 and via fax at 503-418-4750. You can also correspond with Jacy A. Stauffer through the mailing address at 3181 SW SAM JACKSON PARK RD, PORTLAND, OR - 97239-3011 (mailing address contact number: 503-418-5799).

Location: 3181 Sw Sam Jackson Park Rd, Portland, OR, 97239-3011
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Provider Profile Details
NPI Number
1699974014
Provider Name
Jacy A. Stauffer
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
3181 Sw Sam Jackson Park Rd, Portland, OR, 97239-3011
Phone Number
503-418-5799
Fax Number
503-418-4750
Provider Enumeration Date
07/16/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
119591300 05 MD
institution
Provider Business Practice Location Address Details
Address
3181 Sw Sam Jackson Park Rd
City
State
Zip
97239-3011
Phone Number
503-418-5799
Fax Number
503-418-4750
person
Provider Business Mailing Address Details
Address
3181 Sw Sam Jackson Park Rd
City
State
Zip
97239-3011
Phone Number
503-418-5799
Fax Number
503-418-4750
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
License No.
LL738 (Maryland)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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