Organization
BRADFORD H KORN DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADFORD HENRY KORN DDS (PRESIDENT)
(260) 432-3588
Entity
Organization
Contact information
Practice address
4656 W JEFFERSON BLVD, SUITE 220, FORT WAYNE, IN 46804-6857
(260) 432-3588
(260) 459-0729
Mailing address
4656 W JEFFERSON BLVD, SUITE 220, FORT WAYNE, IN 46804-6857
(260) 432-3588
(260) 459-0729
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
12007256
IN
Other
Enumeration date
10/10/2006
Last updated
08/22/2020
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