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Individual

DR. BRADLEY R SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D., D.H.SC.

Contact information

Practice address
1475 S 20TH AVE, SAFFORD, AZ 85546-4053
(928) 428-1617
Mailing address
1475 S 20TH AVE, SAFFORD, AZ 85546-4053
(480) 832-0631

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DD3526
NM
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8251
AZ

Other

Enumeration date
10/19/2011
Last updated
10/19/2011
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