Individual
DR. DEREK S YOUNGBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1740 W 17TH AVE, EUGENE, OR 97402-3619
(541) 484-1835
(541) 504-3907
Mailing address
PO BOX 490, REDMOND, OR 97756-0092
(866) 268-9631
(541) 504-3907
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9621
OR
Other
Enumeration date
07/25/2011
Last updated
07/25/2011
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