| NPI | 1942221551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MATTHEW ROSS Owner/Operator 503-363-6892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6659) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-22 |