| NPI | 1265907364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN N WATKINS Owner/Dentist 541-603-6696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2024-08-19 |