| NPI | 1255762449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA S YARBOROUGH Pediatric Dentist 503-692-3747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR D9222) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |