Individual
THERESA C ASPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
375 PARK AVE STE 7-8, COOS BAY, OR 97420-2244
(541) 269-1317
(541) 269-7817
Mailing address
375 PARK AVE STE 7-8, COOS BAY, OR 97420-2244
(541) 269-1317
(541) 269-7817
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7841
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D7841
DENTIST
OR
Enumeration date
11/02/2006
Last updated
07/08/2007
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