| NPI | 1023559069 |
|---|---|
| Doing Business As | POWELL VALLEY DENTAL |
| Entity Type | Organization |
| Authorized Contact | RYAN WAYNE CARPENTER Owner/President 503-539-0595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D8618) |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-09 |