Individual
DR. BRADLEY RICHARD SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MSD
Contact information
Practice address
54505 26TH STREET, UNIT E, SOUTH BEND, IN 46635
(574) 807-9050
Mailing address
3316 S. TWYCKENHAM DRIVE, SOUTH BEND, IN 46614
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
12010670A
IN
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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