| Alan Liesinger Dmd Pc | |
|
375 Park Ave., Suite 7 Coos Bay OR 97420-2242 | |
| (541) 267-2329 | |
| (541) 267-4026 |
| Full Name | Alan Liesinger Dmd Pc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 375 Park Ave., Suite 7, Coos Bay, Oregon |
| Authorized Official Name and Position | Susan Leslie Liesinger (OFFICE MANAGER) |
| Authorized Official Contact | 5412692329 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alan Liesinger Dmd Pc 375 Park Ave., Suite 7 Coos Bay OR 97420-2242 Ph: (541) 267-2329 | Alan Liesinger Dmd Pc 375 Park Ave., Suite 7 Coos Bay OR 97420-2242 Ph: (541) 267-2329 |
| NPI Number | 1568711257 |
|---|---|
| Provider Enumeration Date | 09/10/2012 |
| Last Update Date | 09/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568711257 | NPI | - | NPPES |
| 168369 | Other | WELFARE PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 667595 (Oregon) | Primary |
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