Individual
DR. KEYAN BOTSFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, MSD
Contact information
Practice address
1625 E MCANDREWS RD STE B, MEDFORD, OR 97504-5334
(541) 779-3003
Mailing address
1625 E MCANDREWS RD STE B, MEDFORD, OR 97504-5334
(541) 779-3003
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D10917
OR
Other
Enumeration date
10/06/2018
Last updated
08/14/2019
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