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Contact Information

JERRY L BRADLEY, DDS
512 COKE AVENUE
EDENTON, NC27932
 Phone: 252-482-1080
 Fax: 252-482-1082
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for JERRY L BRADLEY · (Male)

NPI # 1184713505
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 10/12/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 5267
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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