Individual
LINH TRUONG BRADBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
10915 BAYMEADOWS RD STE 106, JACKSONVILLE, FL 32256-9131
(904) 619-6478
(904) 580-4262
Mailing address
5911 TIMUQUANA RD STE 202, JACKSONVILLE, FL 32210-8174
(904) 993-6088
(904) 993-6088
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN19050
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN19050
STATE DENTAL LICENSE
FL
Enumeration date
08/16/2010
Last updated
06/03/2022
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