Individual
DR. BRADLEY CARLSON LOUIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4255 PACIFIC AVE, SUITE 1, STOCKTON, CA 95207-7638
(209) 478-5616
(209) 478-0556
Mailing address
4255 PACIFIC AVE, SUITE 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
11/09/2006
Last updated
07/08/2007
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