person
Julie Kolstad Clark
Denturist in Roseburg, Oregon
NPI 1609589837

Julie Kolstad Clark is a Denturist based in Roseburg, OR. Julie Kolstad Clark practices in Roseburg, OR. The NPI Number for Julie Kolstad Clark is 1609589837 and holds a License No. DT-TMP-10228509 (Oregon).

The current practice location address for Julie Kolstad Clark is 150 Ne Kenneth Ford Dr, Roseburg, OR and can be reached out via phone at 541-672-9596. You can also correspond with Julie Kolstad Clark through the mailing address at 847 SE BLAKELEY AVE, ROSEBURG, OR - 97470-4828 (mailing address contact number: 541-817-2181).

Location: 150 Ne Kenneth Ford Dr, Roseburg, OR, 97470-4828
person
Provider Profile Details
NPI Number
1609589837
Provider Name
Julie Kolstad Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
150 Ne Kenneth Ford Dr, Roseburg, OR, 97470-4828
Phone Number
541-672-9596
Fax Number
Provider Enumeration Date
01/03/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
150 Ne Kenneth Ford Dr
City
State
Zip
97470-1042
Phone Number
541-672-9596
Fax Number
person
Provider Business Mailing Address Details
Address
150 Ne Kenneth Ford Dr
City
State
Zip
97470-1042
Phone Number
541-672-9596
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Denturist
Speciality
-
Taxonomy
License No.
DT-TMP-10228509 (Oregon)
Definition
Definition to come.
semi-verified symbol
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