| NPI | 1114924933 |
|---|---|
| Doing Business As | FAMILY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY R. HARBOLT President 503-551-6349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OR D6816) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2012-09-10 |