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Individual

DR. ROBERT WAYNE BRUECHERT II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
2730 SW MOODY AVE, PORTLAND, OR 97201-5042
(360) 694-0355
(360) 735-7607
Mailing address
2730 SW MOODY AVE, PORTLAND, OR 97201-5042
(360) 694-0355
(360) 735-7607

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6061
OR
1223G0001X
General Practice Dentistry
5990
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
502-3429
WA
Enumeration date
07/20/2006
Last updated
01/05/2016
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