| NPI | 1760748602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK STEVEN KEENER Dentist 541-548-4064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6719) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |