| NPI | 1619428281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DALLAS BATEMAN Owner 503-375-0007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OR D8364) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |