Individual
DR. CHARLES PEDIGO BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
220 CONWAY ST, SUITE 2, FRANKFORT, KY 40601-2748
(502) 223-4120
(502) 223-4166
Mailing address
220 CONWAY ST, SUITE 2, FRANKFORT, KY 40601-2748
(502) 223-4120
(502) 223-4166
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4154
KY
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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