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Individual

JOHN MATTHEW TRIPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
EPDH, LD

Contact information

Practice address
212 NE SAVAGE ST STE B, GRANTS PASS, OR 97526-1361
(541) 476-8338
Mailing address
4542 AVERILL DR, GRANTS PASS, OR 97526-4114
(541) 295-1264

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT-DO-10189132
OR
124Q00000X
Dental Hygienist
H5633
OR

Other

Enumeration date
02/24/2011
Last updated
12/20/2019
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