| NPI | 1881813798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN MARIE GLENN Front Office Coordinator 541-482-1744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D4836) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |