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General NPI Number Information
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NPI Number | 1831617968
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Entity Type | Individual
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Provider Name | EDUARDO RAMIREZ LD.
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Gender | Male
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Dates
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Enumeration Date | 09/08/2017
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Last Update Date | 09/08/2017
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Provider Practice Location Address
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Address Line | 696 NE WINCHESTER ST
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City | ROSEBURG
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State | OR
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Zip | 97470-3260
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Country | US
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Telephone | 541-673-2724
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Fax | 541-440-6906
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Provider Business Mailing Address
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Address Line | 696 NE WINCHESTER ST UNIT A
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City | ROSEBURG
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State | OR
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Zip | 97470-3260
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Country | US
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Telephone | 541-673-2724
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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 | 122400000X
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Taxonomy Name | Denturist
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License Number | DT-DO-10185813
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License Number State | OR
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