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1356900872
BRADLEY LANCE
O FALLON, MO
NPI
1356900872
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: MO 2019019262)
Enumeration Date
2019-06-08
Last Update Date
2019-06-08
Business Address
Dr. BRADLEY LANCE DDS
7766 WINGHAVEN BLVD
O FALLON, MO 63368-3601
Phone number: 636-561-4117
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Mailing Address
Dr. BRADLEY LANCE DDS
13510 BECKER PLACE DR
SAINT LOUIS, MO 63128-4198
Phone number: 314-605-3402
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