Individual
BRADLEY MORGAN JETTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
4005 BROADWAY ST, HOUSTON, TX 77087-4703
(713) 644-4331
(713) 644-1975
Mailing address
4005 BROADWAY ST, HOUSTON, TX 77087-4703
(713) 644-4331
(713) 644-1975
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
27218
TX
Other
Enumeration date
12/15/2011
Last updated
12/15/2011
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