| NPI | 1780962498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL ALLEN ROTHFUS Owner 541-621-9730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D7419) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2011-07-28 |