Individual
DR. BRADFORD WILLIAM HARPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1120 PARKWAY DR, BLACKFOOT, ID 83221-1651
(208) 785-0878
Mailing address
1120 PARKWAY DR, BLACKFOOT, ID 83221-1651
(208) 785-0878
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3225
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0028012
—
ID
Enumeration date
02/29/2008
Last updated
02/29/2008
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