| NPI | 1003065251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD KENNEDY Owner/Dentist 503-289-0230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6716) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2024-10-30 |