BANDON COASTAL DENTAL, LLC

BANDON, OR
NPI1063756401
Entity TypeOrganization
Authorized ContactPAUL MORRIS PANTLEO
Owner
541-329-0550
Organization Subpart ?No
Primary Taxonomy261Q00000X Clinic/Center
(Licence: OR  D9802)
Enumeration Date2012-11-26
Last Update Date2012-11-26
Business Address
BANDON COASTAL DENTAL, LLC
1097 BALTIMORE AVE
BANDON, OR 97411
Phone number: 541-329-0550
Mailing Address
BANDON COASTAL DENTAL, LLC
PO BOX 429 1097 BALTIMORE AVE
BANDON, OR 97411
Phone number: 541-329-0550