| NPI | 1174810519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER AVERY Office Manager 503-378-1212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D4142) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2011-07-06 |