| NPI | 1861591679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANE E SMITH Owner 541-756-3683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D4773) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |