| NPI | 1518453570 | 
|---|---|
| Doing Business As | CORVALLIS DENTAL GROUP | 
| Entity Type | Organization | 
| Authorized Contact | ROSE GREYSLAK Dentist 503-830-3812 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D10104) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D10127) | 
| Enumeration Date | 2018-07-02 | 
| Last Update Date | 2018-07-02 |