| NPI | 1962765453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREAVOR D FISHER Dentist 541-554-4734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9340) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2012-06-19 |