| NPI | 1730578360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS T PHAM President/Dentist 503-641-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA DE 60190120) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |