Individual
DR. BRADLEY GORDON BORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
511 COLUMBIA STREET, MEDIAPOLIS, IA 52637
(319) 394-3255
(319) 394-3133
Mailing address
511 COLUMBIA STREET, MEDIAPOLIS, IA 52637
(319) 394-3255
(319) 394-3133
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5675
IA
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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