| NPI | 1700245339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JACOB SMITH Owner 541-884-1331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: OR D9136) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2021-12-03 |