| Crisdental Salem L.l.c. | |
|
1355 Edgewater St Nw Salem OR 97304-4077 | |
| (503) 588-6960 | |
| Not Available |
| Full Name | Crisdental Salem L.l.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1355 Edgewater St Nw, 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 Salem L.l.c. 1333 W Harvard Ave Roseburg OR 97471-2838 Ph: (541) 672-2747 | Crisdental Salem L.l.c. 1355 Edgewater St Nw Salem OR 97304-4077 Ph: (503) 588-6960 |
| NPI Number | 1760741078 |
|---|---|
| Provider Enumeration Date | 05/07/2012 |
| Last Update Date | 05/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760741078 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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