| NPI | 1710380886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRINITY E GEMMILL Office Manager 503-625-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D8900) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D9975) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2014-10-03 |