| NPI | 1649762824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEKSANDR PETROVICH LYASHENKO Dentist 503-348-5245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR D10146) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-06-04 |