Individual
DR. DANIEL JORDAN DECILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1144 IOWA ST STE A, ASHLAND, OR 97520
(541) 482-4995
Mailing address
1144 IOWA ST STE A, ASHLAND, OR 97520-2385
(541) 482-4995
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11005
OR
Other
Enumeration date
04/12/2018
Last updated
07/06/2019
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