Individual
DR. JEFF E CHILDRETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1150 CRATER LAKE AVE STE E, MEDFORD, OR 97504-6213
(541) 772-8846
(541) 732-1878
Mailing address
1150 CRATER LAKE AVE STE E, MEDFORD, OR 97504-6213
(541) 772-8846
(541) 732-1878
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7790
OR
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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