Individual
WYATT EDWARD OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 MARKET ST, LEBANON, OR 97355-2334
(541) 570-5818
Mailing address
29186 SANTIAM TERRACE RD, LEBANON, OR 97355-9001
(541) 570-5818
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11855
OR
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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