| NPI | 1306951074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW RALPH BAUMGARTH President/Endodontist 503-698-4484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR D7910) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |