CANADA CONVERSE

BANDON, OR
NPI1972898336
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy124Q00000X Dental Hygienist
(Licence: OR  H4973)
Enumeration Date2011-06-14
Last Update Date2011-06-14
Business Address
-- CANADA CONVERSE RDH, LAP, BA
60140 SEVEN DEVILS RD
BANDON, OR 97411-7358
Phone number: 541-260-8082
Mailing Address
-- CANADA CONVERSE RDH, LAP, BA
60140 SEVEN DEVILS RD
BANDON, OR 97411-7358
Phone number: 541-260-8082