Provider Demographics
NPI:1316003957
Name:STARR, DUANE TERRELL (DMD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:TERRELL
Last Name:STARR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36801 SE PROCTOR RD
Mailing Address - Street 2:
Mailing Address - City:BORING
Mailing Address - State:OR
Mailing Address - Zip Code:97009-9719
Mailing Address - Country:US
Mailing Address - Phone:503-254-7385
Mailing Address - Fax:503-257-3135
Practice Address - Street 1:316 SE 80TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1526
Practice Address - Country:US
Practice Address - Phone:503-254-7385
Practice Address - Fax:503-257-3135
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD62021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice