| NPI | 1669710331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY MCALLISTER Partner 503-620-2807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OR D6900) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2015-08-24 |