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1487546305
BRADLEY WALLACE
SANDY, UT
NPI
1487546305
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: UT 14228509-9926)
Enumeration Date
2025-07-16
Last Update Date
2025-07-16
Business Address
BRADLEY WALLACE DMD
853 E 9400 S
SANDY, UT 84094-3655
Phone number: 801-572-5550
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Mailing Address
BRADLEY WALLACE DMD
5327 W CANARY GRASS WAY
SOUTH JORDAN, UT 84009-1399
Phone number: 801-662-8371
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