Provider Demographics
NPI:1326104076
Name:STINCHFIELD, KENNETH MARNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:MARNE
Last Name:STINCHFIELD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6950 NE CAMPUS WAY
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5611
Mailing Address - Country:US
Mailing Address - Phone:503-952-2125
Mailing Address - Fax:503-526-4418
Practice Address - Street 1:405 SE 133RD AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-1809
Practice Address - Country:US
Practice Address - Phone:503-255-7188
Practice Address - Fax:503-261-0971
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORD81791223S0112X, 1223S0112X
WADE000058711223S0112X
IDD-3945-OS1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery