| NPI | 1063847390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARATI KALLURI Owner/Manager 503-523-6505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9118) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |