| NPI | 1205135118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA ANN MARTINEZ Office Manager 503-968-2901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D7467) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2012-11-28 |