| NPI | 1093097958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT COLBY Dental Office Manager 503-387-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR 126800000X) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2021-06-01 |