Individual
BRADLEY THOMAS SIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2701 NICOLLET AVENUE, MINNEAPOLIS, MN 55408
(612) 874-7674
Mailing address
2969 LAKESHORE AVENUE, MAPLE PLAIN, MN 55359
(763) 479-1492
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10924
MN
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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