Peticolas, Cynthia Marion
Peticolas, Cynthia Marion is an sole proprietor health care provider with primary practice located at 548 S 1St Ave , Mill City OR 97360. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Peticolas, Cynthia Marion can be contacted via phone (503) 897-2353.Contact Information
Primary practice address
548 S 1St Ave
Mill City OR 97360
Phone: (503) 897-2353
Fax: (503) 897-2354
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 5986 | Oregon |
Profile Details
| NPI number | 1134180714 |
|---|---|
| LBN Legal business name | Peticolas, Cynthia Marion |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 31st, 2006 |
| Last updated | May 26th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134180714 | NPPES |
| Oregon | MEDICAID | 265439 |
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