NPI | 1104148816 |
---|---|
Entity Type | Organization |
Authorized Contact | BENJAMIN LARSON HUNSAKER Dentist/Owner 503-363-2536 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6671) |
Enumeration Date | 2010-02-22 |
Last Update Date | 2010-02-22 |