| NPI | 1255791117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW M SHEPPARD Dentist 503-636-8154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D8984) |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2016-03-07 |