Individual
DR. CHADWYCK R BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2050 A SECOND STREET SE, KIRTLAND AFB, NM 87117-5153
(505) 846-3027
Mailing address
2050 A SECOND ST SE, KIRTLAND AFB, NM 87117-0001
(505) 846-3027
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
58624
CA
122300000X
Dentist
D7651
AZ
122300000X
Dentist
Primary
DD3940
NM
Other
Enumeration date
08/28/2008
Last updated
03/26/2021
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