Individual
BRADLEY E AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1560 BEAM AVE STE A, MAPLEWOOD, MN 55109-1191
(651) 777-0788
(651) 777-3463
Mailing address
1560 BEAM AVE STE A, MAPLEWOOD, MN 55109-1191
(651) 777-0788
(651) 777-3463
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11104
MN
Other
Enumeration date
08/16/2006
Last updated
05/01/2008
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