# JESSE C. BRADFORD, D.D.S., P.L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114340700
- **Authorized official:** DR. JESSE C BRADFORD D.D.S. (PRESIDENT)
- **Authorized official phone:** (704) 364-8685

## Contact information

- **Practice address:** 319 S SHARON AMITY RD STE 100, CHARLOTTE, NC 28211-2834
- **Practice address phone:** (704) 364-8685
- **Practice address fax:** (704) 364-8632
- **Mailing address:** 319 S SHARON AMITY RD STE 100, CHARLOTTE, NC 28211-2834
- **Mailing address phone:** (704) 364-8685
- **Mailing address fax:** (704) 364-8632

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8780 | NC | Yes |

## Other

- **Enumeration date:** 02/02/2014
- **Last updated:** 02/02/2014