NPI | 1295080836 |
---|---|
Entity Type | Organization |
Authorized Contact | DEREK W. CONKLIN Dentist/Owner/ President 503-762-2525 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: OR D8325) |
Enumeration Date | 2012-07-19 |
Last Update Date | 2012-07-19 |