| NPI | 1164844494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE DYSERT Executive VP Of Operations 541-504-3900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D4459) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-01-06 |