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Individual

DR. ROBERTS JOSEPH BRADFORD SR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
600 TUSCULUM BLVD, SUITE 1, GREENEVILLE, TN 37745-3951
(423) 638-5141
(423) 638-5131
Mailing address
600 TUSCULUM BLVD, SUITE 1, GREENEVILLE, TN 37745-3951
(423) 638-5141
(423) 638-5131

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS001655
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3212523
TN
Enumeration date
11/03/2005
Last updated
07/08/2007
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