Organization
ATHENS AREA PEDIATRIC DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY J. BRADLEY DMD (OWNER,DMD)
(706) 769-1994
Entity
Organization
Contact information
Practice address
1091 PARK DR, STE A, WATKINSVILLE, GA 30677-2014
(706) 769-1994
(706) 769-1997
Mailing address
PO BOX 1619, WATKINSVILLE, GA 30677-0032
(706) 769-1994
(706) 769-1997
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
010004
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000300671J
—
GA
Enumeration date
01/27/2007
Last updated
01/21/2014
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