Individual
JAKOB BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
33 W 300 S, PAYSON, UT 84651-2801
(801) 465-3233
Mailing address
33 W 300 S, PAYSON, UT 84651-2801
(801) 465-3233
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
128766599921
UT
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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