Individual
DR. PAUL PANTLEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1097 BALTIMORE AVE SE., BANDON, OR 97411-8855
(541) 329-0550
(541) 329-0309
Mailing address
1097 BALTIMORE AVE, BANDON, OR 97411
(541) 329-0550
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9802
OR
Other
Enumeration date
09/03/2008
Last updated
12/03/2012
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