| NPI | 1215275730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOD MATTHEW HARDIN President 503-666-2196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |