Organization
PALM BEACH ENDODONTICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH W. BRADSHAW D.M.D. (PRESIDENT)
(561) 630-8900
Entity
Organization
Contact information
Practice address
11211 PROSPERITY FARMS RD, SUITE B107, PALM BEACH GARDENS, FL 33410-3446
(561) 630-8900
(561) 630-8909
Mailing address
11211 PROSPERITY FARMS RD, SUITE B107, PALM BEACH GARDENS, FL 33410-3446
(561) 630-8900
(561) 630-8909
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
DN13841
FL
1223E0200X
Endodontics
Primary
DN13872
FL
1223E0200X
Endodontics
DN16549
FL
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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