Individual
JACOB LORENZA ATKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
475 SW 12TH ST, ONTARIO, OR 97914-3201
(541) 881-8700
Mailing address
475 SW 12TH ST, ONTARIO, OR 97914-3201
(541) 881-8700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9126
OR
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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