| Bradley Vergien Dds, Llc | |
|
1421 Us 491 Gallup NM 87301 | |
| (505) 863-8000 | |
| Not Available |
| Full Name | Bradley Vergien Dds, Llc |
|---|---|
| Speciality | Dentist |
| Location | 1421 Us 491, Gallup, New Mexico |
| Authorized Official Name and Position | Bradley Vergien (OWNER) |
| Authorized Official Contact | 5058799191 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley Vergien Dds, Llc 1600 Milda St Gallup NM 87301-6117 Ph: (505) 879-9191 | Bradley Vergien Dds, Llc 1421 Us 491 Gallup NM 87301 Ph: (505) 863-8000 |
| NPI Number | 1417275165 |
|---|---|
| Provider Enumeration Date | 05/05/2010 |
| Last Update Date | 05/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417275165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD1926 (New Mexico) | Primary |
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