| NPI | 1164414470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY D ERICKSON President Dentist 541-476-3419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 5491) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2020-08-22 |