| NPI | 1588816557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOZE GHOMGHALEH Owner 503-626-7323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D7585) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D7365) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-11-04 |