Individual
MARK BRADLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
625 S DUKE ST, LANCASTER, PA 17602-4509
(717) 299-6371
Mailing address
9306 VANGUARD CT, OWINGS MILLS, MD 21117-8291
(912) 414-2740
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS040480
PA
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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