| NPI | 1619199007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK RICHMOND President 503-667-1431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D6660D7053) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |