Provider Demographics
NPI:1699026682
Name:DUANE T. STARR DMD, PC
Entity Type:Organization
Organization Name:DUANE T. STARR DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:TERRELL
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-254-7385
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
Mailing Address - Country:US
Mailing Address - Phone:503-348-5527
Mailing Address - Fax:
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
Practice Address - Country:US
Practice Address - Phone:503-254-7385
Practice Address - Fax:503-668-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR62021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty