Individual
SPENCER BURNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1150 CRATER LAKE AVE, SUITE L, MEDFORD, OR 97504-6213
(541) 499-0292
Mailing address
10712 S HOLLOW CV, SANDY, UT 84070-5296
(206) 450-1885
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10464
OR
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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