| NPI | 1992085252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN PETERSON Owner/Dentist 503-390-4117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OR D8434) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2011-08-18 |