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Individual

SUSAN MILLIE FAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
2650 WASHBURN WAY, SUITE 240, KLAMATH FALLS, OR 97603
(541) 363-0201
Mailing address
P.O. BOX 1932, KLAMATH FALLS, OR 97601
(810) 343-1467

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11945
OR

Other

Enumeration date
12/19/2006
Last updated
05/08/2024
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