| NPI | 1528376233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD HORACEK Owner 503-256-3199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D8874) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D9242) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-15 |