| NPI | 1255518577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ELLIOTT CROMPTON Owner 541-386-3848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6493) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2008-01-29 |