Individual
DIANNE ELLIOTT BRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DA II
Contact information
Practice address
318 TURNERSBURG HWY, STATESVILLE, NC 28625-2798
(704) 878-5300
Mailing address
318 TURNERSBURG HWY, STATESVILLE, NC 28625-2798
(704) 878-5300
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
126800000X
NC
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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