Individual
DR. BRADLEY LELAND VAN MIERLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1459 HUMBOLDT RD, SUITE A, CHICO, CA 95928
(530) 899-7804
(530) 899-1246
Mailing address
1459 HUMBOLDT RD, SUITE A, CHICO, CA 95928
(530) 899-7804
(530) 899-1246
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
26138
CA
Other
Enumeration date
08/26/2006
Last updated
07/08/2007
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