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1063756401
BANDON COASTAL DENTAL, LLC
BANDON, OR
NPI
1063756401
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Entity Type
Organization
Authorized Contact
PAUL MORRIS PANTLEO
Owner
541-329-0550
Organization Subpart ?
No
Primary Taxonomy
261Q00000X Clinic/Center
(Licence: OR D9802)
Enumeration Date
2012-11-26
Last Update Date
2012-11-26
Business Address
BANDON COASTAL DENTAL, LLC
1097 BALTIMORE AVE
BANDON, OR 97411
Phone number: 541-329-0550
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Mailing Address
BANDON COASTAL DENTAL, LLC
PO BOX 429 1097 BALTIMORE AVE
BANDON, OR 97411
Phone number: 541-329-0550
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