| NPI | 1194083428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA MARCOULLIER Dentist 503-472-2181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D7797) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2012-04-24 |