| NPI | 1700909314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL F. STAPLETON Owner 503-642-1535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OR 4779) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |