| NPI | 1528235314 |
|---|---|
| Doing Business As | LAKE GROVE DENTAL |
| Entity Type | Organization |
| Authorized Contact | CATHERINE GW MAURER Office Manager 503-636-3641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR 3288) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2008-05-12 |