Organization
W ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADFORD WASHINGTON DMD (OWNER)
(914) 821-5400
Entity
Organization
Contact information
Practice address
95 CHURCH STREET, SUITE 400, WHITE PLAINS, NY 10601
(914) 821-5400
Mailing address
95 CHURCH STREET, SUITE 400, WHITE PLAINS, NY 10601
(914) 821-5400
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
056598
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03610515
—
NY
Enumeration date
11/15/2016
Last updated
11/16/2016
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