Tad Wylie Burzynski L.D., R.D.H.

NPI 1083825962 - Denturist - 122400000X

NPI Details
NPI 1083825962
Gender Male
Enumeration Date 05/24/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
853 NE 4TH ST
BEND OR, 97701-4709, US
Phone (541) 389-7485
Fax (541) 322-0557
Business Location
853 NE 4TH ST.
BEND OR, 97701, US
Phone (541) 389-7485
Fax (541) 322-0557
Toxanomy
Taxonomy Code 122400000X
License State Oregon
License Number DT-DO 557317
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According to our database, Mr. Tad Wylie Burzynski L.D., R.D.H. NPI is 1083825962, taxonomy code is 122400000X and license number is DT-DO 557317, license state is located at Oregon. Tad Wylie Burzynski L.D., R.D.H. physically located at 853 Ne 4th St, Bend OR, 97701-4709. NPI Number Tad Wylie Burzynski L.D., R.D.H. has the Individual type.

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1083825962 NPI number is provided on an as is basis without warranty of any kind. 1083825962 is maintained by the National Plan & Provider Enumeration System. The contents of Tad Wylie Burzynski L.D., R.D.H. are for informational purposes only.