| NPI | 1003247099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY W TIMM President 541-382-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 5817) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2013-12-02 |