Organization
DAMON G BRADFORD DDS LTD
Active
Other names
Dental Specialty
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LILA C WALIMAA (BOOKKEEPER SECRETARY)
(318) 388-2630
Entity
Organization
Contact information
Practice address
2005 FORSYTHE AVE, MONROE, LA 71201
(318) 388-2630
(318) 322-4537
Mailing address
2005 FORSYTHE AVE, MONROE, LA 71201
(318) 388-2630
(318) 322-4537
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
04/09/2007
Last updated
08/22/2020
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