| NPI | 1336624246 |
|---|---|
| Doing Business As | PACIFIC PARK FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | SCOTT GOURLEY Chief Financial Officer 503-840-8925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2022-11-28 |