| NPI | 1790051399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE A CARTER Office Administrator 503-873-8335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D5446) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |