Individual
MICHAEL ALTON BAGAASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
175 W B ST, BLDG F, SPRINGFIELD, OR 97477-4575
(541) 746-8295
Mailing address
175 W B ST, BLDG F, SPRINGFIELD, OR 97477-4575
(541) 746-8295
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5634
OR
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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