Individual
REBECCA B BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
201 PROVIDENCE RD, CHARLOTTE, NC 28207-1417
(704) 376-6470
(704) 496-2988
Mailing address
201 PROVIDENCE RD, CHARLOTTE, NC 28207-1417
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10726
NC
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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