Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JERRY L BRADLEY, DDS
ActiveDR. JERRY L BRADLEY, DDS is a Dentist healthcare provider located in EDENTON, North Carolina. NPI 1184713505 is currently active in the NPPES registry. Verify at CMS.
Dentist · EDENTON, NC
Registration Details
- NPI Number
- 1184713505
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 12, 2006 (19.814636767022 yrs)
- Last Updated
- Jul 8, 2007
- License
-
5267 (NC)
Practice Information
- Address
-
512 COKE AVENUEEDENTON, NC, 27932Browse NC providers · Browse ZIP 27932
- Phone
- 2524821080
- Fax
- 2524821082
- Primary Specialty
-
Dentist
122300000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.