Bradley Family Dental Group, Inc.
Organization Active NPI General Practice Dentistry · Brown Deer, WI
NPI 1851607600 · NPPES record last updated Aug 30, 2010
Key facts
- NPI
- 1851607600
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5519-15 (WI)
- Legal business name
- BRADLEY FAMILY DENTAL GROUP, INC.
- Practice address
- 5600 W Brown Deer Rd
Suite G5
Brown Deer, WI 53223-2311 - Phone
- (414) 371-2506
- Fax
- (414) 371-2509
- NPI assigned
- Aug 30, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Emmanuel Igwike, DDS
- Title
- Owner
- Phone
- (414) 371-2808
National Provider Directory
Locations
5600 W Brown Deer Rd
Ste G5
Brown Deer, WI 53223
Phone (414) 371-2506
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 5519-15 | WI | Yes |
Addresses
Primary practice location
5600 W Brown Deer Rd
Suite G5
Brown Deer, WI 53223-2311
Mailing address
5600 W Brown Deer Rd
Suite G5
Brown Deer, WI 53223-2311
Phone (414) 371-2506
Other providers in Brown Deer, WI
- Corey Black
- Ashley Bland
- Carly Bolli
- Nicholas Boortz
- Amanda Borchardt
- Arlene Magon Braker
- Christina Brigham
- Samantha Ann Broghammer
- Barbara Ann Brown
- Carolyn Brown
All providers in Brown Deer, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.