| NPI | 1235249160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS P CLARK President 503-245-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D7829) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-04-01 |