Individual
DENNIS REID KANTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
820 E MAIN ST, SUITE A, MEDFORD, OR 97504-7121
(541) 772-5504
Mailing address
820 E MAIN ST, SUITE A, MEDFORD, OR 97504-7121
(541) 772-5504
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1353AT
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154864
—
OR
Enumeration date
04/12/2006
Last updated
05/13/2010
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