Individual
BRADLEY EARL HETHERINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
2458 WESTCLIFFE LN, #A, WALNUT CREEK, CA 94597-3280
(925) 457-9620
Mailing address
2458 WESTCLIFFE LN, #A, WALNUT CREEK, CA 94597-3280
(925) 457-9620
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
27013
CA
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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