LIBERTY DENTURE CLINIC, LLC (NPI# 1376862953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376862953 |
| Entity Type | Organization |
| Organization Name | LIBERTY DENTURE CLINIC, LLC |
| Practice Address |
1678 Liberty St Se Suite #202 Salem OR 97302-4348 |
| Practice Telephone | 5033630629 |
| Mailing Telephone | 5033630629 |
| Enumeration Date | 2010-05-22 |
| Last Update Date | 2010-05-22 |
| Authorized Official Name | OSWALDO GONZALEZ CANTARERO (DENTURIST) |
| Authorized Official Telephone | 5033630629 |
| Authorized Official Credential | LD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
DT-DO-10122043 | OR | Ambulatory Health Care Facilities |
| Street Address |
1678 LIBERTY ST SE SUITE #202 |
| City | SALEM |
| State | OR |
| Zip Code | 97302-4348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700825247 | Mark Rogers | Dentist | 1678 Liberty St Se, Suite 101, Salem, OR 97302-4348 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427533637 | Paul K Shivers Dds | Clinic/Center | 2951 St Rt 45 S, Salem, OH 44460-9465 | 2018-10-03 |
| 1437669967 | Salem Family Dental, LLC | Clinic/Center | 100 N Harrison St, Salem, IN 47167-1426 | 2017-10-11 |
| 1063936458 | Hallmark Dental Salem LLC | Clinic/Center | 260 Essex St, Salem, MA 01970-3434 | 2017-07-27 |
| 1497276729 | Family & Restorative Dentistry | Clinic/Center | 7137 236th Ave Ste 108, Salem, WI 53168-8975 | 2017-06-27 |
| 1457759425 | Hulse Dentisry LLC | Clinic/Center | 601 N State Road 198, Salem, UT 84653-4504 | 2014-12-08 |
| 1720338668 | Healthy Smiles Family Dental | Clinic/Center | 2601 25th St Se Ste 400, Salem, OR 97302-1284 | 2012-09-18 |
| 1275894867 | Ous Oregon Institute of Technology | Clinic/Center | 4000 Lancaster Drive Ne, Dental Hygiene 8/ 101, Salem, OR 97305 | 2012-05-31 |
| 1366700791 | Neighborhood Pediatric Dentistry, LLC | Clinic/Center | 1109 Liberty Cir S, Salem, OR 97306-2435 | 2012-04-23 |
| 1679839120 | Stiles Family Dentistry, P.C. | Clinic/Center | 32 Stiles Rd Ste 205, Salem, NH 03079-2893 | 2012-04-10 |
| 1477666535 | Dental Health Group, Terrence P. Flinn, D.d.s., Ted A Schuster, D.d.s. | Clinic/Center | 1410 E State St, Salem, OH 44460-2329 | 2006-08-15 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.