Individual
DR. NICHOLAS BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
21 PEACE ST, PROVIDENCE, RI 02907-1510
(401) 456-2001
Mailing address
19 BERWICK PL, RUMFORD, RI 02916-1911
(703) 505-6813
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DEN.00205417
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/01/2021
Last updated
06/02/2023
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