Provider Demographics
NPI:1912904889
Name:RICE, KRIS EUGENE (DMD)
Entity type:Individual
Prefix:DR
First Name:KRIS
Middle Name:EUGENE
Last Name:RICE
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 1:10340 SE DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-1253
Mailing Address - Country:US
Mailing Address - Phone:503-256-3199
Mailing Address - Fax:503-256-9383
Practice Address - Street 1:10340 SE DIVISION ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-1253
Practice Address - Country:US
Practice Address - Phone:503-256-3199
Practice Address - Fax:503-256-9383
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR58151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice