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1417275165
BRADLEY VERGIEN DDS, LLC
GALLUP, NM
NPI
1417275165
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Entity Type
Organization
Authorized Contact
BRADLEY VERGIEN
Owner
505-879-9191
Organization Subpart ?
No
Primary Taxonomy
122300000X Dentist
(Licence: NM DD1926)
Enumeration Date
2010-05-05
Last Update Date
2010-05-05
Business Address
BRADLEY VERGIEN DDS, LLC
1421 US 491
GALLUP, NM 87301
Phone number: 505-863-8000
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Mailing Address
BRADLEY VERGIEN DDS, LLC
1600 MILDA ST
GALLUP, NM 87301-6117
Phone number: 505-879-9191
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