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Organization
BRADLEY A. ELI DENTAL CORPORATION
Active
Organization
BRADLEY A. ELI DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY ALLEN ELI DMD (PRESIDENT)
(760) 436-4062
Entity
Organization
Contact information
Practice address
2095 W VISTA WAY STE 218, VISTA, CA 92083-6029
(760) 436-6365
(760) 436-5123
Mailing address
2095 W VISTA WAY STE 218, VISTA, CA 92083-6029
(760) 436-6365
(760) 436-5123
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X2210X
Orofacial Pain Dentistry
Primary
—
NULL
1223X2210X
Orofacial Pain Dentistry
Primary
—
—
125Q00000X
Oral Medicine Dentistry
—
NULL
125Q00000X
Oral Medicine Dentistry
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
05/11/2026
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