| NPI | 1700374154 |
|---|---|
| Doing Business As | SPROUT PEDIATRIC DENTISTRY & ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | DANA FOX Manager 503-223-5039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2018-05-01 |