| NPI | 1366700791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY C PHILLIPS President 503-363-8466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR D6697) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2012-04-23 |