| NPI | 1588992317 |
|---|---|
| Other Name | N/A |
| Entity Type | Organization |
| Authorized Contact | JOVAN M GVOZDEN General Dentist 503-853-5284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OR D8856) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2009-12-07 |