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General NPI Number Information
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NPI Number | 1477761484
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Entity Type | Individual
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Provider Name | DOYLE VANBUREN DMD
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1847 PIONEER PKWY E
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City | SPRINGFIELD
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State | OR
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Zip | 97477-3907
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Country | US
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Telephone | 541-746-7630
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Fax |
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Provider Business Mailing Address
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Address Line | 820 W 36TH AVE
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City | EUGENE
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State | OR
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Zip | 97405-2349
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Country | US
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Telephone | 541-746-7630
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D-1742
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License Number State | OR
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