Bradley W Roberts Dmd Pc

NPI 1396899878 - Oral & Maxillofacial Surgery - 204E00000X

NPI Details
NPI 1396899878
Enumeration Date 01/22/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name BRADLEY WANE BRADLEY
Position PRESIDENT
Phone (618) 465-9000
Fax
Practice Location
4 PROFESSIONAL DRIVE
ALTON IL, 62002, US
Phone (618) 465-9000
Fax
Business Location
4 PROFESSIONAL DRIVE
ALTON IL, 62002, US
Phone (618) 465-9000
Fax
Toxanomy
Taxonomy Code 204E00000X
License State
License Number
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According to our database, Bradley W Roberts Dmd Pc NPI is 1396899878, taxonomy code is 204E00000X Bradley W Roberts Dmd Pc physically located at 4 Professional Drive, Alton IL, 62002. NPI Number 1033115704 has the healthcare provider type.

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1396899878 NPI number is provided on an as is basis without warranty of any kind. 1396899878 is maintained by the National Plan & Provider Enumeration System. The contents of Bradley W Roberts Dmd Pc are for informational purposes only.