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Contact Information

BRADLEY ARCHIBALD, DDS
4001 HIGHWAY 104
IONE, CA95640
 Phone: 209-274-4911
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for BRADLEY ARCHIBALD · (Male)

NPI # 1083897029
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 12/13/2007
Last updated 12/13/2007 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 40134
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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