| Bradford B. Liles, Dmd, Pc | |
|
5721 Highway 90 Ste A Theodore AL 36582-3601 | |
| (251) 653-1300 | |
| (251) 653-1242 |
| Full Name | Bradford B. Liles, Dmd, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5721 Highway 90 Ste A, Theodore, Alabama |
| Authorized Official Name and Position | Bradford Bowen Liles (OWNER/DENTIST) |
| Authorized Official Contact | 2516531300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradford B. Liles, Dmd, Pc 5721 Highway 90 Ste A Theodore AL 36582-3601 Ph: (251) 653-1300 | Bradford B. Liles, Dmd, Pc 5721 Highway 90 Ste A Theodore AL 36582-3601 Ph: (251) 653-1300 |
| NPI Number | 1649670936 |
|---|---|
| Provider Enumeration Date | 08/25/2014 |
| Last Update Date | 08/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649670936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5762 (Alabama) | Primary |
Lee Redditt Dmd, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5721 Highway 90 Ste A, Theodore, AL 36582 Phone: 251-653-1242 Fax: 251-653-1242 |