Individual
BENJAMIN J DRIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1651 NW HUGHWOOD CT, ROSEBURG, OR 97471-8834
(541) 672-8187
(541) 672-0224
Mailing address
299 HIDDEN VALLEY LN, ROSEBURG, OR 97471-8255
(503) 956-1066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9318
OR
Other
Enumeration date
06/01/2011
Last updated
06/01/2011
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