Individual
DR. BRADLEY LANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7766 WINGHAVEN BLVD, O FALLON, MO 63368-3601
(636) 561-4117
Mailing address
13510 BECKER PLACE DR, SAINT LOUIS, MO 63128-4198
(314) 605-3402
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2019019262
MO
Other
Enumeration date
06/08/2019
Last updated
06/08/2019
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