| NPI | 1588809974 |
|---|---|
| Other Name | LAKE OSWEGO PERIODONTICS AND IMPLANT DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MATT JAMES HOIDAL President 503-635-3584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR D9075) |
| Enumeration Date | 2008-12-13 |
| Last Update Date | 2012-09-26 |