Fuller, Bradley
Fuller, Bradley is an individual health care provider with primary practice located at 2458 Se Burnside Rd , Gresham OR 97080-1247. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Fuller, Bradley can be contacted via phone (503) 666-8045.Contact Information
Primary practice address
2458 Se Burnside Rd
Gresham OR 97080-1247
Phone: (503) 666-8045
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D7229 | Oregon |
Profile Details
| NPI number | 1073730784 |
|---|---|
| LBN Legal business name | Fuller, Bradley |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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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