Individual
DR. TYLOR DANIEL BREKKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
536 SE OAK ST, HILLSBORO, OR 97123-4118
(503) 648-7775
Mailing address
2730 SW MOODY AVE, SD-ORTHO, PORTLAND, OR 97201-5042
(504) 459-7940
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D11229
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
Other
Enumeration date
07/24/2018
Last updated
04/06/2021
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