| NPI | 1205101490 |
|---|---|
| Doing Business As | SW PORTLAND PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MELISSA J WAGES Owner 503-244-9073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR 10347) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2023-12-28 |