| NPI | 1942573118 |
|---|---|
| Doing Business As | GRESHAM PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JIYOUNG LEE Owner 503-666-9436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OR D8776) |
| Enumeration Date | 2012-02-17 |
| Last Update Date | 2020-06-23 |