Gourley, Jefferson B
Gourley, Jefferson B is an individual health care provider with primary practice located at 3490 Lancaster Dr Ne , Salem OR 97305-1356. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Gourley, Jefferson B can be contacted via phone (855) 433-6825.Contact Information
Primary practice address
3490 Lancaster Dr Ne
Salem OR 97305-1356
Phone: (855) 433-6825
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | DE60502349 | Washington |
| Dental Providers / Endodontics | 1223E0200X | D11009 | Oregon |
Profile Details
| NPI number | 1003941170 |
|---|---|
| LBN Legal business name | Gourley, Jefferson B |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2007 |
| Last updated | May 19th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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