| NPI | 1538460571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE LOREE Practice Management 503-551-0865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 10757) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2010-11-08 |