| NPI | 1467673590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA R JACKSON Dentist/Owner 541-342-2477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 4876) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-10-02 |