Provider Demographics
NPI:1447259635
Name:WORK, BRIAN THEODORE (DMD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:THEODORE
Last Name:WORK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 WILLAGILLESPIE RD
Mailing Address - Street 2:#225
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6798
Mailing Address - Country:US
Mailing Address - Phone:541-747-8272
Mailing Address - Fax:541-741-4841
Practice Address - Street 1:1045 WILLAGILLESPIE RD
Practice Address - Street 2:#225
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-747-8272
Practice Address - Fax:541-741-4841
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD65691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice