# BRADLEY P LACONI DDS PC

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

## Provider details

- **NPI number:** 1285020560
- **Authorized official:** DR. BRADLEY P LACONI DDS (OWNER)
- **Authorized official phone:** (765) 378-0271

## Contact information

- **Practice address:** 11 SKYVIEW DR, CHESTERFIELD, IN 46017-1057
- **Practice address phone:** (765) 378-0271
- **Practice address fax:** (765) 378-4364
- **Mailing address:** 11 SKYVIEW DR, CHESTERFIELD, IN 46017-1057
- **Mailing address phone:** (765) 378-0271
- **Mailing address fax:** (765) 378-4364

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 12008802A | IN | Yes |

## Other

- **Enumeration date:** 04/13/2015
- **Last updated:** 04/13/2015