Individual
DR. THOMAS CARLETON BORDIERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2137 NE 4TH ST, BEND, OR 97701-3824
(541) 389-4807
Mailing address
2137 NE 4TH ST, BEND, OR 97701-3824
(541) 389-4807
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11421
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2019
Last updated
06/17/2021
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