| Crisdental Grants Pass Llc | |
|
934 Ne 8th St Grants Pass OR 97526-1641 | |
| (541) 492-1687 | |
| (866) 216-6527 |
| Full Name | Crisdental Grants Pass Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 934 Ne 8th St, Grants Pass, Oregon |
| Authorized Official Name and Position | Michael J Bratland (OWNER) |
| Authorized Official Contact | 5414921687 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crisdental Grants Pass Llc Po Box 1405 Roseburg OR 97470-0338 Ph: (541) 492-1687 | Crisdental Grants Pass Llc 934 Ne 8th St Grants Pass OR 97526-1641 Ph: (541) 492-1687 |
| NPI Number | 1790239697 |
|---|---|
| Provider Enumeration Date | 08/09/2016 |
| Last Update Date | 08/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790239697 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D8594 (Oregon) | Primary |
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