| NPI | 1063726644 |
|---|---|
| Other Name | CORNELL FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | RANDALL N FREED Owner/Dentist 503-646-9687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: OR 5171) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2010-08-05 |