# FAMILY DENTISTRY BY DESIGN

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

## Provider details

- **NPI number:** 1982076097
- **Authorized official:** DR. KELLY BRADLEY DMD (OWNER / DENTIST)
- **Authorized official phone:** (928) 897-9946

## Contact information

- **Practice address:** 1848 HOPE AVE, SUITE 2, KINGMAN, AZ 86401-4190
- **Practice address phone:** (928) 753-5200
- **Practice address fax:** (928) 753-5205
- **Mailing address:** 1848 HOPE AVE, SUITE 2, KINGMAN, AZ 86401-4190
- **Mailing address phone:** (928) 753-5200
- **Mailing address fax:** (928) 753-5205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7614 | AZ | Yes |

## Other

- **Enumeration date:** 10/28/2015
- **Last updated:** 10/28/2015