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 |