| NPI | 1366655938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN W. HUMBLE President 503-650-6116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D7053) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |