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Contact Information

BRADLEY G BORK, DDS
511 COLUMBIA STREET
MEDIAPOLIS, IA52637
 Phone: 319-394-3255
 Fax: 319-394-3133
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for BRADLEY G BORK · (Male)

NPI Number 1972534527
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 07/05/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • IA License # 5675
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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