| NPI | 1306115803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER LEE HUMPHREY Registered Dental Hygienist 541-815-3985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OR h5866) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: OR H5866) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2011-12-29 |