Individual
BRADLEY MYCHEL PELHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3795 N STOCKTON HILL RD, KINGMAN, AZ 86409-3057
(928) 352-8132
Mailing address
3149 PALO VERDE BLVD N, LAKE HAVASU CITY, AZ 86404-1470
(626) 623-9449
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
109057
CA
122300000X
Dentist
Primary
D011911
AZ
122300000X
Dentist
DB-2023-0196
NM
Other
Enumeration date
07/24/2023
Last updated
08/20/2025
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