Organization
BRADLEY JOHNSON D.M.D., M.S.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY R JOHNSON D.M.D, M.S.D. (ORTHODONTIST)
(440) 946-0088
Entity
Organization
Contact information
Practice address
7288 MENTOR AVE, MENTOR, OH 44060-7578
(440) 946-0088
Mailing address
4310 LANDER RD, CHAGRIN FALLS, OH 44022-1434
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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