| NPI | 1457875700 |
|---|---|
| Doing Business As | LAKE OSWEGO ORTHODONTICS & PERIODONTICS |
| Doing Business As | LAKE OSWEGO PERIODONTICS |
| Doing Business As | LAKE OSWEGO ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | VANESSA N B PETERSON Orthodontist, Member Of LLC 909-518-7743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2018-06-16 |