Provider Demographics
NPI:1891857462
Name:BITNER, DANIEL POULSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:POULSON
Last Name:BITNER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:911 COUNTRY CLUB RD
Mailing Address - Street 2:SUITE # 140
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6044
Mailing Address - Country:US
Mailing Address - Phone:541-484-0470
Mailing Address - Fax:541-484-1552
Practice Address - Street 1:911 COUNTRY CLUB RD
Practice Address - Street 2:SUITE # 140
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6044
Practice Address - Country:US
Practice Address - Phone:541-484-0470
Practice Address - Fax:541-484-1552
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD88521223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics