| NPI | 1073227294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKA MIYAMOTO Dentist / Owner 503-705-8648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-01-11 |
| Last Update Date | 2024-04-02 |