| NPI | 1396800330 |
|---|---|
| Doing Business As | OHSU RUSSELL STREET DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | JOE E ROBERTSON President 503-494-8252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |