| 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 |