Individual
DR. BRADLEY RICHARD OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4572 FRANKLIN RD SW, ROANOKE, VA 24014-5144
(540) 769-5020
(540) 769-5021
Mailing address
4572 FRANKLIN RD SW, ROANOKE, VA 24014-5144
(540) 769-5020
(540) 769-5021
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401415365
VA
1223G0001X
General Practice Dentistry
0401415365
VA
Other
Enumeration date
08/08/2016
Last updated
08/08/2016
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