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General NPI Number Information
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NPI Number | 1093568354
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Entity Type | Organization
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Legal Business Name | ELCIK AND BORDIERI, LLC
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 850 SW 7TH ST
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City | REDMOND
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State | OR
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Zip | 97756-2759
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Country | US
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Telephone | 541-526-0019
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Fax |
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Provider Business Mailing Address
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Address Line | 850 SW 7TH ST
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City | REDMOND
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State | OR
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Zip | 97756-2759
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Country | US
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Telephone | 541-526-0019
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. THOMAS CARLETON BORDIERI
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Credential | DMD
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Telephone | 619-550-6379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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