| NPI | 1780072751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE LOPEZ Financial COO Rdinator 503-223-7682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OR 4969) |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2016-03-18 |