Individual
DAVID RUSSELL DAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.D.
Contact information
Practice address
1055 COURT ST, MEDFORD, OR 97501-5727
(541) 773-3551
(541) 776-4911
Mailing address
1055 COURT ST, MEDFORD, OR 97501-5727
(541) 773-3551
(541) 776-4911
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT-DO-237679
OR
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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