Organization
FAMILY DENTISTRY BY DESIGN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY BRADLEY DMD (OWNER / DENTIST)
(928) 897-9946
Entity
Organization
Contact information
Practice address
1848 HOPE AVE, SUITE 2, KINGMAN, AZ 86401-4190
(928) 753-5200
(928) 753-5205
Mailing address
1848 HOPE AVE, SUITE 2, KINGMAN, AZ 86401-4190
(928) 753-5200
(928) 753-5205
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7614
AZ
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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