| NPI | 1548417934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA M H Office Manager 541-776-6996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 0900022340) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2008-08-27 |