| NPI | 1962930362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABEL AHUMADA ALANIZ President 503-262-1996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OR D8603) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2022-07-21 |