| NPI | 1023499324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA K TUCKER Doctor/ Owner 541-884-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 15-000001304) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2015-06-11 |