| NPI | 1619180007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A SORENSEN Director 503-639-5136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: OR D7165) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |