Dan Joseph Dettmann, L.D.
Denturist in Corvallis, OR. Individual provider (NPI-1).
NPI number1801034335
StatusActive
Last updated in NPPESJan 21, 2009
Details
- NPI
- 1801034335
- Entity type
- Individual (NPI-1)
- Name
- Dan Joseph Dettmann
- Credential
- L.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 21, 2009
- Last updated
- Jan 21, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122400000X | Denturist | DT-DO-433361 | OR | Yes |
Practice location
33894 Se Eastgate CirCorvallis, OR 97333-2248
Phone 541-754-4901
Mailing address
261 Boden StJunction City, OR 97448-1525
Phone 541-913-5609
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