Organization
CRISDENTAL EAGLE POINT LLC
Active
Parent organization
CRISDENTAL GROUP PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRISDENTAL GROUP PC
Authorized official
MR. MICHAEL BRATLAND DDS (OWNER)
(541) 672-2747
Entity
Organization
Contact information
Practice address
217 W MAIN ST, EAGLE POINT, OR 97524-0450
(541) 672-2747
Mailing address
1333 W HARVARD AVE, ROSEBURG, OR 97471-2838
(541) 672-2747
(866) 216-6527
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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