Individual
MR. TAD WYLIE BURZYNSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.D., R.D.H.
Contact information
Practice address
853 NE 4TH ST, BEND, OR 97701-4709
(541) 389-7485
(541) 322-0557
Mailing address
853 NE 4TH ST., BEND, OR 97701
(541) 389-7485
(541) 322-0557
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT-DO 557317
OR
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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