Organization
LISA M GITELSON DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA M GITELSON DMD PC (DOCTOR OWNER)
(503) 463-4663
Entity
Organization
Contact information
Practice address
4734 RIVER RD N, KEIZER, OR 97303-4536
(503) 463-4663
(503) 463-4666
Mailing address
4734 RIVER RD N, KEIZER, OR 97303-4536
(503) 463-4663
(503) 463-4666
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D7623
OR
Other
Enumeration date
08/29/2005
Last updated
08/06/2008
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