Individual
DR. NEIL WIATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
569 NE CLAY AVE, BEND, OR 97701-5158
(541) 382-0410
Mailing address
20406 MURPHY RD, BEND, OR 97702-3086
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D8597
OR
Other
Enumeration date
09/10/2007
Last updated
09/10/2007
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