| NPI | 1891061784 |
|---|---|
| Doing Business As | EAST MEDFORD DENTAL CLINIC-LA CLINICA |
| Entity Type | Organization |
| Authorized Contact | TARA LYNETTE JEANNOT Chief Operations Officer 541-535-6239 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2019-07-15 |