| NPI | 1306193529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY A JONES CEO 503-371-2424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9498) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D6989) |
| 1223G0001X Dentist, General Practice (Licence: OR D8114) | |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |