Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DTDO1007341 | OR |
NPI | 1710101951 |
---|---|
Provider Name | Mr. Nels Christian Hvass |
First Address | Eugene, OR 97401 |
Second Address | Eugene, OR 97401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |