Individual
EUGENE CHICKINELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
548 PACIFIC AVE, BROOKINGS, OR 97415-8982
(541) 469-4995
(541) 469-4408
Mailing address
PO BOX 8160, BROOKINGS, OR 97415-0381
(541) 469-4995
(541) 469-4408
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4605
OR
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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