Individual
DR. BRADLEY JON ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
4521 38TH AVE S, FARGO, ND 58104-8507
(701) 232-1368
(701) 232-4746
Mailing address
4521 38TH AVE S, FARGO, ND 58104-8507
(701) 232-1368
(701) 232-4746
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2045
ND
Other
Enumeration date
05/18/2009
Last updated
05/18/2009
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