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Organization
GREAT NORTHERN DENTAL ASSOC PC
Active
Organization
GREAT NORTHERN DENTAL ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY W BRADLEY DDS (PRESIDENT)
(906) 786-3814
Entity
Organization
Contact information
Practice address
1100 1ST AVE NORTH, ESCANABA, MI 49829
(906) 786-3814
(906) 786-3881
Mailing address
1100 1ST AVE NORTH, ESCANABA, MI 49829
(906) 786-3814
(906) 786-3881
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/11/2006
Last updated
08/22/2020
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