Individual
BRADLEY SCOTT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1906 MAIN ST, CONWAY, SC 29526-3333
(843) 248-3843
Mailing address
1906 MAIN ST, CONWAY, SC 29526-3333
(843) 248-3843
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
38896
TX
1223G0001X
General Practice Dentistry
Primary
9917
SC
Other
Enumeration date
07/06/2021
Last updated
06/10/2026
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