Individual
TERRY WAYNE BRADIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
367 STATE ROUTE 120, BLDG D, LEBANON, NH 03766-1430
(603) 643-4362
(603) 643-4340
Mailing address
PO BOX 682, 367 ROUTE 120 BLDG D, HANOVER, NH 03755
(603) 643-4362
(603) 643-4340
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NH2106
NH
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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