Individual
DR. BRAD A MAYERLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
14800 KRUSE OAKS BLVD, LAKE OSWEGO, OR 97035-8603
(503) 684-2944
(503) 624-6335
Mailing address
14800 KRUSE OAKS BLVD, LAKE OSWEGO, OR 97035-8603
(503) 684-2944
(503) 624-6335
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6896
OR
Other
Enumeration date
12/16/2010
Last updated
12/16/2010
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