Organization
J. DWIGHT BRADSHAW DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J.DWIGHT BRADSHAW DDS (OWNER)
(757) 484-1444
Entity
Organization
Contact information
Practice address
5501 BENNETTS PASTURE RD STE D, SUFFOLK, VA 23435-1500
(757) 484-1444
(757) 484-3712
Mailing address
5501 BENNETTS PASTURE RD STE D, SUFFOLK, VA 23435-1500
(757) 484-1444
(757) 484-3712
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/22/2008
Last updated
10/22/2008
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