| NPI | 1740561729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS CLARK Business Owner/Dentist 503-622-8211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OR D9460) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2011-09-02 |