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Organization

CORNELIUS TENDERCARE DENTAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JUSTIN R MAROSTICA D.M.D. (PRESIDENT)
(503) 858-0741
Entity
Organization

Contact information

Practice address
1890 BASELINE ST, CORNELIUS, OR 97113-8208
(503) 357-0004
(503) 359-8856
Mailing address
1890 BASELINE ST, CORNELIUS, OR 97113-8208
(503) 357-0004
(503) 359-8856

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9419
OR

Other

Enumeration date
03/17/2014
Last updated
03/17/2014
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