Organization · Type 2 NPI
Bandon Coastal Dental, LLC
Clinic/Center · Bandon, OR
NPI number
1063756401
Active
Practice location
1097 Baltimore Ave
Bandon, OR 97411
Mailing address
PO Box 429, 1097 Baltimore Ave
Bandon, OR 97411
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center Primary | 261Q00000X | D9802 (OR) |
Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
About NPI 1063756401
Bandon Coastal Dental, LLC's National Provider Identifier is 1063756401, issued on Nov 26, 2012. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Bandon, OR. The record was last updated on Nov 26, 2012.