Individual
MATTHEW BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
555 W ADAMS ST, BURNS, OR 97720-1408
(541) 573-7778
Mailing address
213 N. ROANOKE, PO BOX 52, HINES, OR 97738
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8282
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
229011
—
OR
Enumeration date
10/11/2006
Last updated
07/08/2007
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