Individual
DANIEL JON DAHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
478 SW 12TH ST, ONTARIO, OR 97914-3202
(541) 881-1794
Mailing address
478 SW 12TH ST, ONTARIO, OR 97914-3202
(541) 881-1794
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11612
OR
Other
Enumeration date
05/18/2022
Last updated
07/06/2022
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