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Organization

BRADLEY A. ELI DENTAL CORPORATION

Active
Parent organization
BRADLEY A. ELI DENTAL CORPORATION
Organization subpart
Yes

Provider details

NPI number
Legal business name
BRADLEY A. ELI DENTAL CORPORATION
Authorized official
DR. BRADLEY ALLEN ELI DND (CEO)
(844) 235-9881
Entity
Organization

Contact information

Practice address
5830 OBERLIN DR STE 202, SAN DIEGO, CA 92121-3754
(844) 235-9881
(760) 436-5123
Mailing address
5830 OBERLIN DR STE 202, SAN DIEGO, CA 92121-3754
(844) 235-9881
(760) 436-5123

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1223X2210X
Orofacial Pain Dentistry

Other

Enumeration date
05/24/2023
Last updated
06/20/2023
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