Provider Demographics
NPI:1548267370
Name:BIERMANN, BRUCE ALAN (DMD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ALAN
Last Name:BIERMANN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 PLEASENT 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
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR59401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice