Individual
AIMEE FOREMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
640 N 16TH ST, COTTAGE GROVE, OR 97424-1202
(541) 510-3460
Mailing address
640 N 16TH ST, COTTAGE GROVE, OR 97424-1202
(541) 510-3460
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H4931
OR
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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