| NPI | 1154624229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW L THOMPSON Dentist/Manager 503-747-3409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OR D7612) |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2010-12-13 |