LIBERTY DENTURE CLINIC LLC NPI 1376862953

NPI Information

NPI: 1376862953
Provider Name: LIBERTY DENTURE CLINIC, LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1678 LIBERTY ST SE
SUITE #202
SALEM, OR
ZIP 97302
Phone: (503) 363-0629
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LIBERTY DENTURE CLINIC, LLC is a dental clinic center in Salem, OR. LIBERTY DENTURE CLINIC, LLC NPI is 1376862953. The provider is registered as an organization entity type.

The provider's business location address is:

1678 LIBERTY ST SE
SUITE #202
SALEM, OR
ZIP 97302-348
Phone: (503) 363-0629

The provider's authorized official is Oswaldo Gonzalez Cantarero .
The authorized official title is Denturist and has the following contact phone number (503) 363-0629.

The enumeration date for this NPI number is 5/22/2010 and was last updated on 5/22/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	DT-DO-10122043	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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