Individual
DR. KATIE ELIZABETH BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
139 ROSE GARDEN LN, GOODLETTSVILLE, TN 37072-3164
(573) 275-3143
Mailing address
139 ROSE GARDEN LN, GOODLETTSVILLE, TN 37072-3164
(573) 275-3143
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
10221
TN
1223G0001X
General Practice Dentistry
10221
TN
Other
Enumeration date
07/06/2012
Last updated
07/11/2016
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