Organization
CRISDENTAL EAST SALEM, LLC
Active
Parent organization
CRISDENTAL GROUP, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRISDENTAL GROUP, PC
Authorized official
MICHAEL J BRATLAND DMD (OWNER)
(541) 672-2747
Entity
Organization
Contact information
Practice address
3545 LANCASTER DR NE, SALEM, OR 97305-1435
(541) 672-2747
(541) 672-2757
Mailing address
3019 NW STEWART PKWY, STE 304, BOX 311, ROSEBURG, OR 97471-1602
(541) 672-2747
(541) 672-2757
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/14/2013
Last updated
02/14/2013
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