| NPI | 1518046564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCY POZDINA Financial Coordinator 503-284-3575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 5687) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR 7674) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-08-22 |