MEDICARE: STEVEN P BRADLEY 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	1223G0001X	General Practice Dentistry	7184	IA

General Provider Information

NPI Number	:	1831127935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN P BRADLEY DDS

Provider Business Mailing Address
First Line	:	714 1ST AVE E
Second Line	:	P.O. BOX 327
City	:	CASCADE
State	:	IA
Zip	:	52033-9799
Country	:	US
Telephone Number	:	563-852-7390
Fax Number	:	563-852-7534

Provider Business Practice Location Address
First Line	:	714 1ST AVE E
Second Line	:
City	:	CASCADE
State	:	IA
Zip	:	52033-9799
Country	:	US
Telephone Number	:	563-852-7390
Fax Number	:	563-852-7534

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/08/2007

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Directions to “ STEVEN P BRADLEY DDS” Practice Location

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