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Organization
MAYERLE DENTAL PC
Active
Organization
MAYERLE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD MAYERLE (PRESIDENT)
(503) 684-2944
Entity
Organization
Contact information
Practice address
14800 KRUSE OAKS BLVD, LAKE OSWEGO, OR 97035-8671
(503) 684-2944
Mailing address
14800 KRUSE OAKS BLVD, LAKE OSWEGO, OR 97035-8671
(503) 684-2944
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6896
OR
Other
Enumeration date
07/02/2014
Last updated
07/02/2014
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