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Organization
THE GROVE DENTAL GP
Active
Organization
THE GROVE DENTAL GP
Active
Other names
The Grove Dental GP
Organization subpart
No
Provider details
NPI number
Authorized official
MICHASEL JACOB BRATLAND DMD (OWNER)
(541) 643-6772
Entity
Organization
Contact information
Practice address
1235 NE 6TH ST, GRANTS PASS, OR 97526-1286
(541) 492-1687
(541) 418-4311
Mailing address
PO BOX 1541, ROSEBURG, OR 97470-0360
(541) 492-1687
(541) 418-4311
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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