| Brad A. Mckenzie | |
|
24540 E Welches Rd Welches OR 97067 | |
| (503) 622-3085 | |
| (503) 622-3753 |
| Full Name | Brad A. Mckenzie |
|---|---|
| Speciality | Dentist |
| Location | 24540 E Welches Rd, Welches, Oregon |
| Authorized Official Name and Position | Brad Mckenzie (DENTIST) |
| Authorized Official Contact | 5036223085 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brad A. Mckenzie Po Box 293 Welches OR 97067-0293 Ph: (503) 622-3085 | Brad A. Mckenzie 24540 E Welches Rd Welches OR 97067 Ph: (503) 622-3085 |
| NPI Number | 1518280072 |
|---|---|
| Provider Enumeration Date | 03/11/2010 |
| Last Update Date | 03/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518280072 | NPI | - | NPPES |
| 1285634097 | Other | OR | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D7819 (Oregon) | Primary |
Robert H Kelly, Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 24540 E Welches Rd, Welches, OR 97067 Phone: 503-622-3085 |