| Crisdental East Salem, Llc | |
|
3545 Lancaster Dr Ne Salem OR 97305-1435 | |
| (541) 672-2747 | |
| (541) 672-2757 |
| Full Name | Crisdental East Salem, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3545 Lancaster Dr Ne, Salem, Oregon |
| Authorized Official Name and Position | Michael J Bratland (OWNER) |
| Authorized Official Contact | 5416722747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crisdental East Salem, Llc 3019 Nw Stewart Pkwy Ste 304, Box 311 Roseburg OR 97471-1602 Ph: (541) 672-2747 | Crisdental East Salem, Llc 3545 Lancaster Dr Ne Salem OR 97305-1435 Ph: (541) 672-2747 |
| NPI Number | 1558601385 |
|---|---|
| Provider Enumeration Date | 02/14/2013 |
| Last Update Date | 02/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558601385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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