| Harvard Endodontics, Llc | |
|
1813 W. Harvard Ave Suite 240 Roseburg OR 97471-8708 | |
| (541) 673-2383 | |
| (541) 440-6319 |
| Full Name | Harvard Endodontics, Llc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 1813 W. Harvard Ave, Roseburg, Oregon |
| Authorized Official Name and Position | Susan Leslie Liesinger (OFFICE MANAGER) |
| Authorized Official Contact | 5416732383 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harvard Endodontics, Llc 1813 W. Harvard Ave Suite 240 Roseburg OR 97471-8708 Ph: (541) 673-2383 | Harvard Endodontics, Llc 1813 W. Harvard Ave Suite 240 Roseburg OR 97471-8708 Ph: (541) 673-2383 |
| NPI Number | 1144657594 |
|---|---|
| Provider Enumeration Date | 10/01/2013 |
| Last Update Date | 10/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144657594 | NPI | - | NPPES |
| D5545 | Other | OR | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | D5545 (Oregon) | Primary |
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