David R Deforest, DDS Valid NPI
Individual provider · Dentist · Oregon, IL
- NPI
- 1487734281
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-10-16
- Last updated
- 2007-07-08
Practice location
606 W Washington St
Oregon, IL 61061
(815) 732-3225