| NPI | 1396912010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE T SOBALVARRO Office Manager 503-297-8866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D7513) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2008-05-12 |