Individual
DR. CHRISTOPHER BRADLEY DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
363 LAKEVIEW CT, COVINGTON, LA 70433-7515
(985) 641-2030
(985) 900-2189
Mailing address
363 LAKEVIEW CT, COVINGTON, LA 70433-7515
(985) 641-2030
(985) 900-2189
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5714
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29783
—
LA
Enumeration date
04/17/2008
Last updated
06/15/2020
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