| NPI | 1962774869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MARGAUX TINKLE General Dentist, Owner 503-348-7396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 60266590) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-08 |