Central Oregon Perio

NPI #1336216373 in Bend, Oregon

Provider Information

NPI Number
1336216373
Entity Type
Organization
Organization Name
Central Oregon Perio
Primary Specialty
Dentist - Periodontics
Enumeration Date
Nov 28, 2006
Last Updated
Jul 9, 2010

Practice Location

Address
1569 SW NANCY WAY STE 3
City
Bend
State
Oregon
ZIP Code
97702
Phone
(541) 317-0255

Authorized Official

Name
NICHOLAS W MISISCHIA, DMD
Title
PRESIDENT
Phone
(541) 317-0255

Specialties & Taxonomy Codes

Specialty
Dentist - PeriodonticsPeriodontics

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