Individual
DR. BRADLEY LERUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
323 N LEROUX ST, FLAGSTAFF, AZ 86001-4540
(928) 774-1168
Mailing address
323 N LEROUX ST, FLAGSTAFF, AZ 86001-4540
(928) 774-1168
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9507
AZ
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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