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Individual

DR. DANTON LAFEY BRADSHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
702 CENTER ST W, KIMBERLY, ID 83341-1722
(208) 423-6444
(208) 423-6903
Mailing address
702 CENTER ST W, KIMBERLY, ID 83341-1722
(208) 423-6444
(208) 423-6903

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4642
ID

Other

Enumeration date
04/07/2015
Last updated
04/07/2015
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