| NPI | 1790169217 |
|---|---|
| Former Legal Business Name | ORTHO COUNTRY ORTHO |
| Entity Type | Organization |
| Authorized Contact | KENT JENSEN CFO 503-472-8320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |