| NPI | 1558033118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE SIRIANNI Ea & Federal Grants Program Manager 503-489-1760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2022-02-24 |