| NPI | 1053066894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M EYRE Owner Of Entity 503-580-6099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2022-02-21 |