Organization
CRISDENTAL GRANTS PASS LLC
Active
Parent organization
CRISDENTAL GROUP PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRISDENTAL GROUP PC
Authorized official
DR. MICHAEL J BRATLAND DMD (OWNER)
(541) 492-1687
Entity
Organization
Contact information
Practice address
934 NE 8TH ST, GRANTS PASS, OR 97526-1641
(541) 492-1687
(866) 216-6527
Mailing address
PO BOX 1405, ROSEBURG, OR 97470-0338
(541) 492-1687
(866) 216-6527
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8594
OR
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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