| NPI | 1093009706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA R OSTERHOLME Office Manager 503-325-3533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR 7028) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2011-05-31 |