| NPI | 1659479095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R SCOTT ROBERTS Owner 541-756-0558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D7517) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |