| NPI | 1679696652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN S LEE President 503-788-1415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D8646) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |