| NPI | 1053614396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES LEE BRANEN Dentist 503-288-6963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR D7206) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2010-12-08 |