| Liberty Denture Clinic, Llc | |
|
1678 Liberty St Se Suite #202 Salem OR 97302-4348 | |
| (503) 363-0629 | |
| Not Available |
| Full Name | Liberty Denture Clinic, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1678 Liberty St Se, Salem, Oregon |
| Authorized Official Name and Position | Oswaldo Gonzalez Cantarero (DENTURIST) |
| Authorized Official Contact | 5033630629 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Denture Clinic, Llc 1678 Liberty St Se Suite #202 Salem OR 97302-4348 Ph: (503) 363-0629 | Liberty Denture Clinic, Llc 1678 Liberty St Se Suite #202 Salem OR 97302-4348 Ph: (503) 363-0629 |
| NPI Number | 1376862953 |
|---|---|
| Provider Enumeration Date | 05/22/2010 |
| Last Update Date | 05/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376862953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DT-DO-10122043 (Oregon) | Primary |
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