Individual
KEIKO THORNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
501 E 7TH ST, THE DALLES, OR 97058-2677
(541) 298-4411
Mailing address
501 E 7TH ST, THE DALLES, OR 97058-2677
(541) 298-4411
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H1710
OR
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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