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Individual

DR. JERALD KYLE HOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
419 STATE ST, STE 4, HOOD RIVER, OR 97031-2075
(541) 387-8688
(541) 387-6785
Mailing address
419 STATE ST, STE 4, HOOD RIVER, OR 97031-2075
(541) 387-8688
(541) 387-6785

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D7666
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
181087
OR
Enumeration date
06/01/2005
Last updated
08/09/2007
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