CRISDENTAL GRANTS PASS LLC

GRANTS PASS, OR
NPI1790239697
Entity TypeOrganization
Authorized ContactMICHAEL J BRATLAND
Owner
541-492-1687
Organization Subpart ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: OR  D8594)
Enumeration Date2016-08-09
Last Update Date2016-08-09
Business Address
CRISDENTAL GRANTS PASS LLC
934 NE 8TH ST
GRANTS PASS, OR 97526-1641
Phone number: 541-492-1687
Mailing Address
CRISDENTAL GRANTS PASS LLC
PO BOX 1405
ROSEBURG, OR 97470-0338
Phone number: 541-492-1687