| NPI | 1437643616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR MERZENICH Clinical Director 503-315-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 4063) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |