| NPI | 1972854628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD C SELIS President 503-287-1554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D6582) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2012-09-20 |