| J. Dwight Bradshaw Dds | |
|
5501 Bennetts Pasture Rd Ste D Suffolk VA 23435-1500 | |
| (757) 484-1444 | |
| (757) 484-3712 |
| Full Name | J. Dwight Bradshaw Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5501 Bennetts Pasture Rd Ste D, Suffolk, Virginia |
| Authorized Official Name and Position | J.dwight Bradshaw (OWNER) |
| Authorized Official Contact | 7574841444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Dwight Bradshaw Dds 5501 Bennetts Pasture Rd Ste D Suffolk VA 23435-1500 Ph: (757) 484-1444 | J. Dwight Bradshaw Dds 5501 Bennetts Pasture Rd Ste D Suffolk VA 23435-1500 Ph: (757) 484-1444 |
| NPI Number | 1568614584 |
|---|---|
| Provider Enumeration Date | 10/22/2008 |
| Last Update Date | 10/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568614584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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