| NPI | 1447515747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN W. BLACK President 503-524-0524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OR D6736) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2012-07-12 |