| Bradley Dental, Llc | |
|
2034 N State Route 50 Bourbonnais IL 60914-4410 | |
| (815) 929-0222 | |
| Not Available |
| Full Name | Bradley Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2034 N State Route 50, Bourbonnais, Illinois |
| Authorized Official Name and Position | Koushan Azad (OWNER/DENTIST) |
| Authorized Official Contact | 8159290222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley Dental, Llc 2034 N State Route 50 Bourbonnais IL 60914-4410 Ph: (815) 929-0222 | Bradley Dental, Llc 2034 N State Route 50 Bourbonnais IL 60914-4410 Ph: (815) 929-0222 |
| NPI Number | 1295906584 |
|---|---|
| Provider Enumeration Date | 03/14/2008 |
| Last Update Date | 03/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295906584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
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