Healthcare Provider Details

I. General information

NPI: 1598993354
Provider Name (Legal Business Name): ROBERT H. BREWER DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 W 6TH ST SUITE 3
THE DALLES OR
97058-1147
US

IV. Provider business mailing address

818 W 6TH ST SUITE 3
THE DALLES OR
97058-1147
US

V. Phone/Fax

Practice location:
  • Phone: 541-296-9134
  • Fax: 541-296-9135
Mailing address:
  • Phone: 541-296-9134
  • Fax: 541-296-9135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELE VAN RIPER
Title or Position: OFFICE MANAGER
Credential:
Phone: 541-296-9134