| NPI | 1740066349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYSON KIRCHHOFER Owner 503-412-8579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2023-09-18 |