Organization
BRADLEY C. LOUIE, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY CARLSON LOUIE DDS (PRESIDENT/OWNER)
(209) 478-5616
Entity
Organization
Contact information
Practice address
4255 PACIFIC AVE STE 1, STOCKTON, CA 95207-7638
(209) 478-5616
(209) 478-0556
Mailing address
4255 PACIFIC AVE STE 1, STOCKTON, CA 95207-7638
(209) 478-5616
(209) 478-0556
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
32739
CA
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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