Individual
DR. MICHAEL EDGAR BRADLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5424 REILLY RD, BLDG 260, POPE AFB, NC 28308-2324
(910) 394-2123
Mailing address
5424 REILLY RD, BLDG 260, POPE AFB, NC 28308-2324
(910) 394-2123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
105047
CO
Other
Enumeration date
10/25/2005
Last updated
07/08/2007
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