| Bradford H Korn Dds, Inc. | |
|
4656 W Jefferson Blvd Suite 220 Fort Wayne IN 46804-6857 | |
| (260) 432-3588 | |
| (260) 459-0729 |
| Full Name | Bradford H Korn Dds, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4656 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Bradford Henry Korn (PRESIDENT) |
| Authorized Official Contact | 2604323588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradford H Korn Dds, Inc. 4656 W Jefferson Blvd Suite 220 Fort Wayne IN 46804-6857 Ph: (260) 432-3588 | Bradford H Korn Dds, Inc. 4656 W Jefferson Blvd Suite 220 Fort Wayne IN 46804-6857 Ph: (260) 432-3588 |
| NPI Number | 1891883633 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891883633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 12007256 (Indiana) | Primary |
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