| NPI | 1285180554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ALSHUQAIRI Practice Advisor 503-931-1775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019022628) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |