Individual
DR. BRADLEY FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
819 MOUNT TABOR RD, NEW ALBANY, IN 47150-6414
(812) 945-7643
Mailing address
954 COTTONWOOD DR, CLARKSVILLE, IN 47129-1042
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012118A
IN
Other
Enumeration date
05/17/2014
Last updated
05/17/2014
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