Individual
PETER DANIEL CARLESIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3490 LANCASTER DR NE, SALEM, OR 97305-1356
(855) 433-6825
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611
(855) 433-6825
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9514
OR
1223G0001X
General Practice Dentistry
DE61007889
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D9514
DENTIST LICENSE
OR
Enumeration date
08/22/2005
Last updated
10/06/2022
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