| NPI | 1649635384 |
|---|---|
| Doing Business As | BROOKSIDE DENTAL - CLACKAMAS |
| Entity Type | Organization |
| Authorized Contact | ROBERT J KOWAL Owner/Dentist 503-905-3380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2018-03-19 |