Individual
KYLE O'HARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
913 A ST, MYRTLE POINT, OR 97458-1334
(541) 559-5000
(541) 516-4035
Mailing address
442 SW UMATILLA AVE STE 200, REDMOND, OR 97756-7039
(888) 468-0022
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D11466
OR
1223G0001X
General Practice Dentistry
Primary
D11466
OR
Other
Enumeration date
07/01/2021
Last updated
07/01/2021
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