| NPI | 1285952754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALYA A JUSON Dentist 503-475-2645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR d9140) |
| Enumeration Date | 2010-05-09 |
| Last Update Date | 2010-05-09 |