| NPI | 1649640434 |
|---|---|
| Doing Business As | TIGARD MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | VIVIAN LAM Owner 503-455-8483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2022-03-09 |