Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 5601 | OR |
NPI | 1063404549 |
---|---|
Provider Name | Dr. Ross George Kaplan |
First Address | Salem, OR 97302-5159 |
Second Address | Salem, OR 97302-5159 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 08/07/2007 |