| NPI | 1073699245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J RUSHFORD President 503-223-0441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D7314) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D3582) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-08-22 |