Individual
SHANNON BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
114 OLD FARMS RD, CHESHIRE, CT 06410-3773
(203) 271-1097
Mailing address
114 OLD FARMS RD, CHESHIRE, CT 06410-3773
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
05954
CT
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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