| NPI | 1316226392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY GIFFEN Office Manager 541-344-0413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 5660) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2011-08-09 |