Individual
JAMES RICHARD SOUTHWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5135 SKYLINE RD S, SALEM, OR 97306-9427
(503) 371-7487
Mailing address
4165 STRATUS CT S, SALEM, OR 97302-2775
(503) 378-7480
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6201
OR
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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