Healthcare Provider Details

I. General information

NPI: 1437139623
Provider Name (Legal Business Name): BRADLEY M WOODHAM D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2669 E SILVER SPRINGS BLVD
OCALA FL
34470-7007
US

IV. Provider business mailing address

2669 E SILVER SPRINGS BLVD
OCALA FL
34470-7007
US

V. Phone/Fax

Practice location:
  • Phone: 352-736-8544
  • Fax:
Mailing address:
  • Phone: 352-736-8544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN 17101
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: