MEDICARE: BRADLEY TODD HALPER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN0010065	FL

General Provider Information

NPI Number	:	1740390509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY TODD HALPER DDS

Provider Business Mailing Address
First Line	:	4477 WOODFIELD BLVD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434
Country	:	US
Telephone Number	:	561-988-3014
Fax Number	:

Provider Business Practice Location Address
First Line	:	7495 WEST ATLANTIC AVE
Second Line	:	STE 208
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446
Country	:	US
Telephone Number	:	561-495-9600
Fax Number	:	561-495-9600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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