Individual
MR. PHILLIP R DAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.D
Contact information
Practice address
1663 W HARVARD AVE, ROSEBURG, OR 97470-2812
(541) 672-0100
(541) 440-8996
Mailing address
14987 N BANK RD, ROSEBURG, OR 97470-7937
(541) 496-3794
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DT DO 869528
OR
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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