Organization
BRADLEY M STEWART DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY MITCHELL STEWART DMD (OWNER)
(901) 262-0217
Entity
Organization
Contact information
Practice address
6855 CRUMPLER BLVD STE 100, OLIVE BRANCH, MS 38654-1930
(901) 262-0217
Mailing address
6855 CRUMPLER BLVD STE 100, OLIVE BRANCH, MS 38654-1930
(901) 262-0217
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3105-99
MS
Other
Enumeration date
11/28/2017
Last updated
11/28/2017
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