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Organization
SEVILLE DENTAL CENTER
Active
Organization
SEVILLE DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE BRADLEY DDS (DENTIST)
(323) 582-6938
Entity
Organization
Contact information
Practice address
7705 SEVILLE AVE, SUITE A, HUNTINGTON PARK, CA 90255-6315
(323) 582-6938
Mailing address
7705 SEVILLE AVE, SUITE A, HUNTINGTON PARK, CA 90255-6315
(323) 582-6938
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
26342
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G9021602
DENTICAL NUMBER
CA
Enumeration date
05/22/2007
Last updated
08/22/2020
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