| NPI | 1376709535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY MASCIOTRA Sr. Assoc. Dean, Clinical Practice 503-494-5099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2021-07-14 |