Organization
TOM LASTER DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELINA RUIZ (FRONT OFFICE)
(541) 758-1505
Entity
Organization
Contact information
Practice address
2444 NW PROFESSIONAL DR, CORVALLIS, OR 97330
(541) 758-1505
Mailing address
2444 NW PROFESSIONAL DR, CORVALLIS, OR 97330-3991
(541) 758-1505
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1223G0001X
OR
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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