Individual
DR. BRADFORD GARRISON TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
801 CRESCENT WAY, SUITE 2, ARCATA, CA 95521-6780
(707) 822-2711
(707) 822-0885
Mailing address
801 CRESCENT WAY, SUITE 2, ARCATA, CA 95521-6780
(707) 822-2711
(707) 822-0885
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
33390
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B33390-01
DENTI-CAL
CA
Enumeration date
09/06/2006
Last updated
07/08/2007
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