| NPI | 1992584288 |
|---|---|
| Doing Business As | NE PORTLAND DENTAL |
| Entity Type | Organization |
| Authorized Contact | JOHN JOONTAE PARK Dentist, Owner 503-348-3207 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-09-26 |
| Last Update Date | 2023-09-26 |