| NPI | 1154415834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON D BLETSCHER Officer 503-861-3707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D5837) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2008-10-06 |