| NPI | 1356771786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOAN THANH PHAN Dental Hygiene 971-222-8003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OR H5284) |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2013-11-21 |