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Contact Information

BRAD E SORENSON, DMD
140 E MAIN STREET
OTHELLO, WA99344
 Phone: 509-488-5256
 Fax: 509-488-9939
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for BRAD E SORENSON · (Male)

NPI Number 1245350693
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 03/30/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • WA License # DE00010850
  • WA Other 0218526 WA STATE D L&I #
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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