| NPI | 1891052122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE NGUYEN Dentist 503-649-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OR D7480) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-04-11 |