Individual
DR. ROBERT J BRISENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
114 MOLLY ST, GLENDALE, OR 97442
(541) 832-2200
(541) 832-2655
Mailing address
PO BOX 407, GLENDALE, OR 97442
(541) 832-2200
(541) 832-2655
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5372
OR
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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