| NPI | 1699908475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J. DOHERTY Surgeon/President 541-776-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: OR D9230) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2020-03-26 |