| NPI | 1902827199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAROLE H WILSON Doctor 503-245-1915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR 7753) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-08-22 |