Bradshaw, Daniel W

Bradshaw, Daniel W is an individual health care provider with primary practice located at 300 W Watauga Ave , Johnson City TN 37604-5549. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Bradshaw, Daniel W can be contacted via phone (423) 929-8111.

Contact Information

Primary practice address
300 W Watauga Ave Johnson City TN 37604-5549
Phone: (423) 929-8111
Fax: (423) 929-8111
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 7691 Tennessee

Profile Details

NPI number 1861405821
LBN Legal business name Bradshaw, Daniel W
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861405821 NPPES
Tennessee Other 16639 TENNCARE/DORAL DENAL

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