| NPI | 1154606853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MATTHEW TRIPP Owner/Dental Hygienist 541-295-1264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR H5633) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2011-10-14 |