| NPI | 1629547682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON WOODS Orthodontist/Owner/Member 541-385-3104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2018-11-20 |