Individual
KEITH FUSAO OGAWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
217 W. MAIN ST., EAGLE POINT, OR 97524
(541) 826-2525
(541) 826-2876
Mailing address
P.O. BOX 236, 217 W. MAIN ST., EAGLE POINT, OR 97524
(541) 826-2525
(541) 826-2876
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6945
OR
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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