| NPI | 1538438296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA V BADGER Owner/Partner 503-288-5891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D7649) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2011-12-23 |