Individual
BRADLEY REDGE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
61 N WILLOW ST, SUITE 1, MESQUITE, NV 89027-4785
(702) 346-2882
Mailing address
983 DIAMOND CIR, MESQUITE, NV 89027-2932
(702) 345-3324
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5115
NV
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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