| NPI | 1245609049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT FRIESS Owner 503-585-0101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2015-09-22 |