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General NPI Number Information
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NPI Number | 1023933421
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Entity Type | Organization
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Legal Business Name | BRADFORD DENTAL LLC
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 33 W 300 S
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City | PAYSON
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State | UT
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Zip | 84651-2801
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Country | US
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Telephone | 801-465-3233
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Fax |
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Provider Business Mailing Address
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Address Line | 509 E 570 S
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City | NEPHI
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State | UT
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Zip | 84648-2166
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER - DENTIST
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Name | JAKOB BRADFORD
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Credential | DDS
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Telephone | 435-660-6392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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