Individual
BRADLEY MICHAEL ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., MD
Contact information
Practice address
200 43RD STREET SE, SUITE D, GRAND RAPIDS, MI 49508
(616) 281-1112
(616) 281-0773
Mailing address
200 43RD STREET SE, SUITE D, GRAND RAPIDS, MI 49508
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901020218
MI
390200000X
Student in an Organized Health Care Education/Training Program
2901020218
MI
Other
Enumeration date
05/21/2010
Last updated
07/20/2016
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