| Bradley L Videen Dds Ms | |
|
140 Birch St N #106 Cambridge MN 55008 | |
| (763) 689-3134 | |
| (763) 689-6609 |
| Full Name | Bradley L Videen Dds Ms |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 140 Birch St N, Cambridge, Minnesota |
| Authorized Official Name and Position | Bradley L Videen (100 PERCENT SHAREHOLDER OF S CORP) |
| Authorized Official Contact | 7636893134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley L Videen Dds Ms 140 Birch St N #106 Cambridge MN 55008 Ph: (763) 689-3134 | Bradley L Videen Dds Ms 140 Birch St N #106 Cambridge MN 55008 Ph: (763) 689-3134 |
| NPI Number | 1124244603 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124244603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 8936 (Minnesota) | Primary |
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