| NPI | 1174073043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE HOLMES Office Manager 541-773-3756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR 1700042313) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-04 |