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General NPI Number Information
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NPI Number | 1134825185
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Entity Type | Organization
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Legal Business Name | J BRADLEY ECKER, DDS PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 413 E MAIN ST
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City | BATAVIA
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State | NY
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Zip | 14020-2437
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Country | US
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Telephone | 858-308-9913
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Fax |
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Provider Business Mailing Address
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Address Line | 413 E MAIN ST
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City | BATAVIA
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State | NY
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Zip | 14020-2437
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Country | US
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Telephone | 858-308-9913
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Fax |
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Authorized Official
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Title or Position | DDS
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Name | BRADLEY ECKER
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Credential |
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Telephone | 585-308-9913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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