| NPI | 1942791215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN ANDREW OGLE Owner/Dentist 503-538-3129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D10303) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2019-06-11 |