Organization
BRACES NOW 14, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH BRADFORD GILBERT DMD (MANAGER/OWNER)
(770) 287-4051
Entity
Organization
Contact information
Practice address
4141 STEVE REYNOLDS BLVD, SUITE 2, NORCROSS, GA 30093
(770) 963-7255
Mailing address
2371 STRAND AVE, DR BRAD GILBERT, LAWRENCEVILLE, GA 30043-8204
(770) 287-4051
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
GA12772
GA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
GA14767
GA
Other
Enumeration date
07/19/2017
Last updated
07/24/2017
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