| NPI | 1790783686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WAYNE SUTTON Owner/Dentist 541-672-4971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN D6820) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2020-08-22 |