Individual
DR. BRADLEY SHANE BARLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
602 N CALGARY CT, SUITE 201, POST FALLS, ID 83854-4000
(208) 777-9331
(208) 777-9335
Mailing address
602 N CALGARY CT, SUITE 201, POST FALLS, ID 83854-4000
(208) 777-9331
(208) 777-9335
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D-3781
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806893400
—
ID
Enumeration date
07/18/2006
Last updated
08/28/2012
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