| NPI | 1821104407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARVEL LERALPH STANDER Owner 503-620-9333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6800) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-08-22 |