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 |