Individual
DR. BRADLEY G ANGELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
10412 SHELBYVILLE RD, LOUISVILLE, KY 40223-3120
(502) 425-3350
(502) 425-3789
Mailing address
10412 SHELBYVILLE RD, LOUISVILLE, KY 40223-3120
(502) 425-3350
(502) 425-3789
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4934
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1695639
UCCI
IN
01
—
506626
UCCI
KY
Enumeration date
11/22/2006
Last updated
07/08/2007
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