| NPI | 1811149297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS D JOHNSON President 503-581-9419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: OR D4839) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |