NPI | 1609878172 |
---|---|
Professional Name | WILLAMETTE VALLEY ORAL & MAXILLOFACIAL SURGERY, INC |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D6585) |
Enumeration Date | 2005-08-13 |
Last Update Date | 2007-07-08 |