# BRADLEY JOHNSON D.M.D., M.S.D., LLC

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

## Provider details

- **NPI number:** 1710573548
- **Authorized official:** BRADLEY R JOHNSON D.M.D, M.S.D. (ORTHODONTIST)
- **Authorized official phone:** (440) 946-0088

## Contact information

- **Practice address:** 7288 MENTOR AVE, MENTOR, OH 44060-7578
- **Practice address phone:** (440) 946-0088
- **Mailing address:** 4310 LANDER RD, CHAGRIN FALLS, OH 44022-1434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/16/2020
- **Last updated:** 12/16/2020