| Bradley G Angell, Dmd, Ms | |
|
10412 Shelbyville Rd Louisville KY 40223-3120 | |
| (502) 425-3350 | |
| (502) 425-3789 |
| Full Name | Bradley G Angell, Dmd, Ms |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 10412 Shelbyville Rd, Louisville, Kentucky |
| Authorized Official Name and Position | Bradley G Angell (OWNER) |
| Authorized Official Contact | 5024253350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley G Angell, Dmd, Ms 10412 Shelbyville Rd Louisville KY 40223-3120 Ph: (502) 425-3350 | Bradley G Angell, Dmd, Ms 10412 Shelbyville Rd Louisville KY 40223-3120 Ph: (502) 425-3350 |
| NPI Number | 1619045739 |
|---|---|
| Provider Enumeration Date | 11/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619045739 | NPI | - | NPPES |
| 506626 | Other | KY | UCCI |
| 1695639 | Other | IN | UCCI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 4934 (Kentucky) | Primary |
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