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Individual

LEAH BOLLE-VAN LOO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1885 WAITE ST, NORTH BEND, OR 97459-1210
(541) 696-5006
(541) 756-6234
Mailing address
1890 WAITE ST STE 1, NORTH BEND, OR 97459-1229
(541) 756-6232
(541) 756-6234

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
002377
OR

Other

Enumeration date
04/08/2025
Last updated
04/08/2025
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