Provider Demographics
NPI:1982875894
Name:BRUCE A. BIERMANN D.M.D.,P.C.
Entity Type:Organization
Organization Name:BRUCE A. BIERMANN D.M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BIERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-668-7421
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-0220
Mailing Address - Country:US
Mailing Address - Phone:503-668-7421
Mailing Address - Fax:503-668-7421
Practice Address - Street 1:39870 SE PLEASANT ST
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055
Practice Address - Country:US
Practice Address - Phone:503-668-7421
Practice Address - Fax:503-668-7421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR59401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty