| NPI | 1275658932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN B BRUNSTON Office Manager 541-753-3883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6926) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2008-09-29 |