| NPI | 1730497868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORNELIUS GEHRED President 503-254-2068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D9242) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D8874) |
| 122300000X Dentist (Licence: OR D4833) | |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |