Individual
ALIJAH BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4267 W COMMERCIAL BLVD, TAMARAC, FL 33319-3305
(954) 677-3202
(954) 677-3201
Mailing address
19255 NE 10TH AVE APT 225, MIAMI, FL 33179-5936
(734) 904-4589
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 20845
FL
Other
Enumeration date
07/31/2014
Last updated
10/29/2014
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