| NPI | 1962747618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EUGENE NEVILLS President 503-649-3232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6095) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2014-09-18 |