| Provider Type: | Dental Providers |
| Provider Classification: | Dentist |
| Provider Specialization: | Oral and Maxillofacial Surgery |
| Definition of Specialization: | |
| Address: |
9430 Sw Coral St Suite 200 Tigard, OR 97223-6691 |
| Phone: | (503) 245-1100 |
| Fax: | (503) 473-8300 |
| Authorized Official: | Dr. Clark, Dennis P, DMD |
| Authorized Official Position: | President |
| Authorized Official Phone: | (503) 245-1100 |
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