Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | 10165090 | OR |
NPI | 1487058822 |
---|---|
Provider Name | Mr. Andrew Mcmurray |
First Address | Oregon City, OR 97045-0305 |
Second Address | Milwaukie, OR 97222-7696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2014 |
Last Update Date | 14/10/2014 |