| NPI | 1669467916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN SCOTT VAN VOORHIS Pesident 503-569-0953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D7405) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D7349) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2020-08-22 |