| NPI | 1780763755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC P BERGQUAM President 503-538-5476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D8310) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-08-22 |