| NPI | 1457722134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON ADAM WHITE Owner/President 541-708-6288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D8919) |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |