| NPI | 1073733259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN ZEPHYR BIZEAU Owner Dentist 503-538-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 8307) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2020-08-11 |