Individual
DR. BRADFORD BOWEN LILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5721 HIGHWAY 90 STE A, THEODORE, AL 36582-3601
(251) 653-1300
(251) 653-1300
Mailing address
5721 HIGHWAY 90 STE A, THEODORE, AL 36582-3601
(251) 653-1300
(251) 653-1300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5762
AL
Other
Enumeration date
06/08/2010
Last updated
08/25/2014
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