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Organization
BRADLEY T FREDERICK DMD LLC
Active
Organization
BRADLEY T FREDERICK DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY FREDERICK DMD (MANAGER)
(502) 552-4559
Entity
Organization
Contact information
Practice address
1935 APPLE BLOSSOM DR, FLOYDS KNOBS, IN 47119-9025
(502) 552-4559
Mailing address
1935 APPLE BLOSSOM DR, FLOYDS KNOBS, IN 47119-9025
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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