| NPI | 1467629527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA L ANDERSON Office Manager 503-636-7010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OR D8267) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2008-05-08 |