Organization
CRISDENTAL MOBILE, LLC
Active
Parent organization
CRISDENTAL PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRISDENTAL PC
Authorized official
DR. MICHAEL JAMES BRATLAND DDS (OWNER)
(541) 672-2747
Entity
Organization
Contact information
Practice address
2530 NW MEDICAL PARK DR, ROSEBURG, OR 97471-5510
(541) 673-6511
(541) 672-2757
Mailing address
3019 NW STEWART PKWY, STE 304, BOX 249, ROSEBURG, OR 97471-1602
(541) 672-2747
(541) 672-2757
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
07/09/2013
Last updated
07/09/2013
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