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General NPI Number Information
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NPI Number | 1013871433
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Entity Type | Organization
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Legal Business Name | DENTURE IN
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 853 NE 4TH ST
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City | BEND
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State | OR
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Zip | 97701-4709
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Country | US
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Telephone | 541-389-7485
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Fax |
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Provider Business Mailing Address
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Address Line | 853 NE 4TH ST
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City | BEND
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State | OR
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Zip | 97701-4709
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Country | US
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Telephone | 541-389-7485
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAD BURZYNSKI
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Credential | L.D.
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Telephone | 541-389-7485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122400000X
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Taxonomy Name | Denturist
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License Number |
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License Number State |
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