| NPI | 1902019565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZ DAUGHERTY Office Manager 541-484-9106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 6534) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |