Individual
DR. MONLEUDY KEO BRACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4072 VICTORY BLVD, PORTSMOUTH, VA 23701-2820
(757) 405-6293
Mailing address
25229 TAYLOR ST APT D, LOMA LINDA, CA 92354-3032
(916) 233-5951
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401412950
VA
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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