Organization
BRADFORD BOYD, DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN GOCKE (CLINIC ADMINISTRATOR)
(661) 942-1179
Entity
Organization
Contact information
Practice address
151 E AVENUE J, LANCASTER, CA 93535-3520
(661) 942-1179
Mailing address
151 E AVENUE J, LANCASTER, CA 93535-3520
(661) 942-1179
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
31212
CA
Other
Enumeration date
07/11/2013
Last updated
07/11/2013
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