| NPI | 1760869143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDI L TJOSTOLVSON Patient Financial Coordinator 971-978-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2019-01-17 |