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1073730784
BRADLEY FULLER
GRESHAM, OR
NPI
1073730784
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: OR D7229)
Enumeration Date
2007-04-20
Last Update Date
2007-07-08
Business Address
DR. BRADLEY FULLER D.D.S.
2458 SE BURNSIDE RD
GRESHAM, OR 97080-1247
Phone number: 503-666-8045
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Mailing Address
DR. BRADLEY FULLER D.D.S.
2458 SE BURNSIDE RD
GRESHAM, OR 97080-1247
Phone number: 503-666-8045
Copy
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