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 |