| NPI | 1861910077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG M LEE Dentist, Owner 503-382-0414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR D10330) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2022-07-21 |