| NPI | 1407014129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL J OLSON Owner 541-673-4152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR 7394) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |