| NPI | 1114063542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY D CARL President 541-926-6089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D7214) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |