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1447258223
GARY THEODORE PEDERSON
SALEM, OR
NPI
1447258223
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: OR D4658)
Enumeration Date
2005-07-14
Last Update Date
2007-07-17
Business Address
-- GARY THEODORE PEDERSON D.D.S.
1565 LIBERTY ST SE
SALEM, OR 97302-4345
Phone number: 503-581-0223
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Mailing Address
-- GARY THEODORE PEDERSON D.D.S.
1565 LIBERTY ST SE
SALEM, OR 97302-4345
Phone number: 503-581-0223
Copy
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