BRADLEY WISOWATY

VALPARAISO, IN
NPI1306229562
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: IN  12012301A)
Additional Taxonomies1223G0001X Dentist, General Practice
(Licence: IN  12012301A)
Enumeration Date2015-07-07
Last Update Date2018-11-27
Business Address
BRADLEY WISOWATY
809 WALL ST STE A
VALPARAISO, IN 46383-2571
Phone number: 219-464-9681
Mailing Address
BRADLEY WISOWATY
809 WALL ST STE A
VALPARAISO, IN 46383-2571
Phone number: