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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BRADLEY RANDALL CONGLETON, DMD

Active

BRADLEY RANDALL CONGLETON, DMD is a Dental Public Health healthcare provider located in LOUISVILLE, Kentucky. NPI 1952754749 is currently active in the NPPES registry. Verify at CMS.

Dental Public Health · LOUISVILLE, KY

Registration Details

NPI Number
1952754749
Provider Type
Individual
Gender
Male
NPI Issued
Jul 18, 2016 (10.066381572502 yrs)
Last Updated
Nov 18, 2024
Licenses
12014346A (IN)
9824 (KY)
9824 (KY)

Practice Information

Address
2215 PORTLAND AVE
LOUISVILLE, KY, 402121033
Browse KY providers · Browse ZIP 40212
Phone
5027748631
Fax
5029968309
Primary Specialty
Dental Public Health
1223D0001X
Additional Specialty
General Dentistry
Additional Specialty
Dental Public Health
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.