Individual
DR. DARREN B. RAVASSIPOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S., PC
Contact information
Practice address
3180 STATE ST STE 102, MEDFORD, OR 97504-8493
(541) 779-6200
(541) 779-6203
Mailing address
3180 STATE ST STE 102, MEDFORD, OR 97504-8493
(541) 779-6200
(541) 779-6203
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D8177
OR
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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