| NPI | 1134180284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANNE MCCOMB Office Mgr 503-223-5223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 5298) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-08-22 |