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Individual

THOMAS WAYNE WESTFALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
94223 4TH ST, GOLD BEACH, OR 97444
(541) 247-7332
(541) 247-9204
Mailing address
PO BOX 772, GOLD BEACH, OR 97444
(541) 247-7332
(541) 247-9204

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4990
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
215277
OR
Enumeration date
01/23/2008
Last updated
01/23/2008
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