NPI | 1235569070 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMARA JUSTUS Owner 503-352-3800 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2013-11-14 |
Last Update Date | 2013-11-14 |