| NPI | 1154763183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH D SHAKESPEAR President 503-325-3533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9903) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2013-07-18 |