Individual
DR. BRADLEY ARCHIBALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4001 HIGHWAY 104, IONE, CA 95640
(209) 274-4911
Mailing address
4001 HIGHWAY 104, IONE, CA 95640
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
40134
CA
Other
Enumeration date
12/13/2007
Last updated
12/13/2007
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