Individual
JACK BENJAMIN DUNHAM JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4000 E 30TH AVE, EUGENE, OR 97405-0640
(541) 463-3000
Mailing address
1640 G ST, SPRINGFIELD, OR 97477-4226
(541) 682-3550
(541) 682-3551
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4322
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4322
STATE LICENSE - DENTIST
OR
Enumeration date
11/09/2009
Last updated
03/07/2023
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