| NPI | 1528842077 |
|---|---|
| Doing Business As | MIDTOWN DENTAL |
| Entity Type | Organization |
| Authorized Contact | SHANE L ELLSWORTH Owner 503-476-5242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-11-26 |