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Individual
BRADLEY JAY MORLOCK
Active
Individual
BRADLEY JAY MORLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D2072PE
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D2072 PE
DENTAL LICENSE
ID
Enumeration date
09/20/2006
Last updated
07/08/2007
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