| NPI | 1164701066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J KRISTEN CAMPBELL Dental Hygienist For Ltd. Access 541-520-5333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OR H2564) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2011-08-09 |