| NPI | 1124583208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAVEENDRA THUSHARA RANASINGHE Partner/General Dentist 503-227-1693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2019-02-04 |