| NPI | 1477939494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS GLENN BROOKS Part Owner 541-855-7920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6262) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |