| NPI | 1780741884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY A ENGLESTADTER President 541-883-7409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OR D7225) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |