Rogue River Denture Service
Dental Laboratory in Grants Pass, OR. Organization (NPI-2).
NPI number1154873271
StatusActive
Last updated in NPPESOct 25, 2016
Details
- NPI
- 1154873271
- Entity type
- Organization (NPI-2)
- Legal business name
- Rogue River Denture Service
- Organization subpart
- No
- Enumeration date
- Oct 25, 2016
- Last updated
- Oct 25, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 292200000X | Dental Laboratory | DT-DO-093102 | OR | Yes |
Practice location
1850 Williams HwyGrants Pass, OR 97527-5662
Phone 541-476-0254 · Fax 541-955-7277
Mailing address
1850 Williams HwyGrants Pass, OR 97527-5662
Phone 541-476-0254 · Fax 541-955-7277
Authorized official
Mitchell K. Sheeler
Denturist
5414760254
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