| NPI | 1891208724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID MILLER Owner 503-944-9374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OR D9312) |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |