Organization
LIBERTY DENTURE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSWALDO GONZALEZ CANTARERO LD (DENTURIST)
(503) 363-0629
Entity
Organization
Contact information
Practice address
1678 LIBERTY ST SE, SUITE #202, SALEM, OR 97302-4348
(503) 363-0629
Mailing address
1678 LIBERTY ST SE, SUITE #202, SALEM, OR 97302-4348
(503) 363-0629
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DT-DO-10122043
OR
Other
Enumeration date
05/22/2010
Last updated
05/22/2010
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