| NPI | 1124390281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAHID THOMAS ESHRAGHI Periodontist 503-799-5383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OR D8855) |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2012-02-06 |