NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1538707294
LAKE OSWEGO MODERN DENTISTRY, PC
PO BOX 920050
DALLAS
TX
753920050
1962137356
NIMMO
JOYCE
LYNETTE
2 JEFFERSON PKWY APT A14
LAKE OSWEGO
OR
970358868
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