Individual
DR. BRADLEY WILLIAM TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
940 BLACK CANYON WAY, MONTROSE, CO 81403-9833
(360) 820-1407
Mailing address
940 BLACK CANYON WAY, MONTROSE, CO 81403-9833
(360) 820-1407
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00202056
CO
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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