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Organization
SUNIL D. THANIK, DMD, MSD, LLC
Active
Organization
SUNIL D. THANIK, DMD, MSD, LLC
Active
Other names
Progressive Periodontics
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA ROCHA (SR CREDENTIALING TEAM LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
12025 SW 70TH AVE, TIGARD, OR 97223-9634
(503) 924-6505
Mailing address
12025 SW 70TH AVE, TIGARD, OR 97223-9634
(503) 924-6505
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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