| NPI | 1720322431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHU THI BUI President/Dentist 503-644-8727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OR D7308) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2012-11-19 |