| NPI | 1588288591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA MEE YOUNG LEE CEO 503-360-8886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2021-11-30 |