| NPI | 1699942060 |
|---|---|
| Former Legal Business Name | DAMON G BRADFORD DDS LTD |
| Entity Type | Organization |
| Authorized Contact | LILA C WALIMAN Bookkeeper Secretary 318-388-2630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: LA 4708) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-05-14 |