Individual
DR. BRADLEY EDHOLM KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
121 E FRONT AVE, BISMARCK, ND 58504-5589
(701) 223-1194
Mailing address
737 MUNICH DR, BISMARCK, ND 58504-7042
(701) 258-7579
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1663
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41242
—
ND
Enumeration date
08/30/2006
Last updated
07/08/2007
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