| NPI | 1023367513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILLIAMS Owner 503-641-4328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 2004) |
| Additional Taxonomies | 122400000X Denturist (Licence: OR 27130) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2012-08-30 |