| NPI | 1467060293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDA STALLINGS Insurance Manager 541-842-7053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-07-17 |