| NPI | 1366756389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN J JOHNSON Oral Surgeon / Owner 503-472-1468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D5964) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D9272) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2010-08-02 |