| NPI | 1376310359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON FALER Executive Director 503-444-6444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-12-08 |
| Last Update Date | 2024-07-01 |