Individual
EDWARD BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1400 6TH AVE S, JEFFERSON COUNTY HEALTH DEPT-CENTRAL DENTAL CLINIC, BIRMINGHAM, AL 35233-1502
(205) 930-1422
(205) 930-1448
Mailing address
1400 6TH AVE S, JEFFERSON COUNTY HEALTH DEPT-CENTRAL DENTAL CLINIC, BIRMINGHAM, AL 35233-1502
(205) 930-1422
(205) 930-1448
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4686
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51513055BRA
BLUE CROSS#-CENTRAL DENTA
AL
01
—
51513056BRA
BLUE CROSS#-BESSEMER DENT
AL
01
—
51513060BRA
BLUECROSS#WESTERN DENTAL
AL
01
—
51513061BRA
BLUE CROSS#EASTERN DENTAL
AL
Enumeration date
10/10/2006
Last updated
08/15/2007
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