| NPI | 1366708372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J ELLIOTT Owner 503-661-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D5163) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2012-04-03 |