Individual
JANINE MARIE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
410 MACON AVE, CANON CITY, CO 81212-3225
(719) 276-0117
Mailing address
1001 S INDIAN BEND DR, PUEBLO WEST, CO 81007-6158
(719) 276-0117
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH.000906087
CO
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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