Provider Demographics
NPI:1174624928
Name:OJA, EUGENE EDWARD JR (DDS)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:EDWARD
Last Name:OJA
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3255
Mailing Address - Street 2:
Mailing Address - City:ESTES PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80517
Mailing Address - Country:US
Mailing Address - Phone:970-586-8180
Mailing Address - Fax:970-586-8180
Practice Address - Street 1:1861 MARYS LAKE ROAD
Practice Address - Street 2:
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517
Practice Address - Country:US
Practice Address - Phone:970-586-8180
Practice Address - Fax:970-586-8180
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6128122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist