Individual
DR. BRADFORD PAUL O'BRIEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
321 9TH ST, SUITE 105, LEAVENWORTH, WA 98826-1464
(509) 548-5415
(509) 548-2434
Mailing address
321 9TH ST, SUITE 105, LEAVENWORTH, WA 98826-1464
(509) 548-5415
(509) 548-2434
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00007080
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5036371
—
WA
01
—
57080
WDS PROVIDER NUMBER
VA
01
—
LABOR AND INDUSTRIES
L&I
WA
Enumeration date
12/01/2005
Last updated
07/09/2007
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