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1649381062
KEVIN M TATLOCK
ONTARIO, OR
NPI
1649381062
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122400000X Denturist
(Licence: OR DT-DO-854277)
Enumeration Date
2006-08-31
Last Update Date
2007-07-09
Business Address
Mr. KEVIN M TATLOCK L.D.
473 SW 12TH ST
ONTARIO, OR 97914-3201
Phone number: 541-889-3282
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Mailing Address
Mr. KEVIN M TATLOCK L.D.
473 SW 12TH ST
ONTARIO, OR 97914-3201
Phone number: 541-889-3282
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