| NPI | 1417307513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MCLEOD Dentist 503-332-8118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9515) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2016-06-20 |