Individual
PETER M OLLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
836 E MAIN ST, STE #2, MEDFORD, OR 97504-7115
(541) 858-0740
(541) 776-5342
Mailing address
846 BLACKBERRY LN, ASHLAND, OR 97520-1459
(541) 708-0347
(802) 748-8513
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9378
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000-1944
—
VT
05
—
9900-1944
—
NH
Enumeration date
09/16/2006
Last updated
09/09/2010
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