| NPI | 1063173466 |
|---|---|
| Doing Business As | RUSSELL MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SUMEET S. PANDHOH Owner 503-295-2120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2022-01-07 |