Individual
DR. BRAD A BAGWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., P.A.
Contact information
Practice address
7171 N COCOA BLVD, COCOA, FL 32927-5094
(321) 631-5558
(321) 632-3226
Mailing address
7171 N COCOA BLVD, COCOA, FL 32927-5094
(321) 631-5558
(321) 632-3226
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15097
FL
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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