| NPI | 1063766251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY ALLEN CASTLE President 503-701-0191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR D9350) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2017-02-28 |