| NPI | 1497207492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN WANG Owner 503-228-1506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-10-26 |