| NPI | 1821256827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARGUERITE GREENE Dentist 503-666-2515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D8789) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D8881) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-05-27 |