Organization
ROGUE RIVER DENTURE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL K. SHEELER L.D (DENTURIST)
(541) 476-0254
Entity
Organization
Contact information
Practice address
1850 WILLIAMS HWY, GRANTS PASS, OR 97527-5662
(541) 476-0254
(541) 955-7277
Mailing address
1850 WILLIAMS HWY, GRANTS PASS, OR 97527-5662
(541) 476-0254
(541) 955-7277
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
DT-DO-093102
OR
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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