Individual
DR. BENJAMIN WADE HASLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2222 NW LINCOLN AVE, CORVALLIS, OR 97330-2503
(541) 754-4017
Mailing address
2222 NW LINCOLN AVE, CORVALLIS, OR 97330-2503
(541) 754-4017
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10522
OR
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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