Crisdental Salem L.l.c.

NPI #1760741078 in Salem, Oregon

Provider Information

NPI Number: 1760741078
Entity Type: Organization
Organization Name: Crisdental Salem L.l.c.
Subpart: Yes (part of a larger organization)
Parent Organization: CRISDENTAL P.C.
Primary Specialty: Dentist - General Practice
Enumeration Date: May 7, 2012
Last Updated: May 7, 2012

Practice Location

Address: 1355 EDGEWATER ST NW
City: Salem
State: Oregon
ZIP Code: 97304-4077
Phone: (503) 588-6960

Authorized Official

Name: MICHAEL J BRATLAND, D.M.D.
Title: OWNER
Phone: (541) 672-2747

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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