| NPI | 1619248960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBI M HUYSSOON President 503-970-3844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D8624) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-01-18 |