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 |