Arthur Eugene Bradley, DDS
Individual provider Active NPI Dentist · Ft Gordon, GA
NPI 1992750418 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992750418
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 1041-61 (MS)
- Practice address
- BLDG 38717 38TH Street
USA Dentac
Ft Gordon, GA 30905-5660 - Phone
- (706) 787-6927
- Fax
- (706) 787-2082
- NPI assigned
- May 23, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1041-61 | MS | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1041-61 | MS | Yes |
Addresses
Primary practice location
BLDG 38717 38TH Street
USA Dentac
Ft Gordon, GA 30905-5660
Mailing address
BLDG 38717 38TH Street
USA Dentac
Ft Gordon, GA 30905-5660
Phone (706) 787-6927
Other providers in Ft Gordon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.