| NPI | 1659632677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL L ECKLUND Office Manager 503-644-2910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OR D9096) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-06 |