Individual
DR. BRAD HARGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
411 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052
(618) 498-6493
(618) 498-6493
Mailing address
411 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2027
(618) 498-6493
(618) 498-6493
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019.026811
IL
1223G0001X
General Practice Dentistry
Primary
019026811
IL
Other
Enumeration date
11/30/2006
Last updated
03/04/2024
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