| NPI | 1376646901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA VON HUSEN BADGER Owner 503-288-5891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D7649) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2009-08-13 |