Individual
ALBERT ANSELMO CACCIVIO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DENTURIST
Contact information
Practice address
905 RIVER RD, EUGENE, OR 97404-3228
(541) 461-2020
Mailing address
905 RIVER RD, EUGENE, OR 97404-3228
(541) 461-2020
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT-DO-461580
OR
Other
Enumeration date
10/26/2012
Last updated
10/26/2012
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