| NPI | 1790035426 | 
|---|---|
| Doing Business As | NORTHWEST DENTAL OF CORVALLIS | 
| Entity Type | Organization | 
| Authorized Contact | JONATHAN D. SMART President 541-757-7708 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D8256) | 
| Enumeration Date | 2012-09-10 | 
| Last Update Date | 2012-09-10 |