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General NPI Number Information
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NPI Number | 1275845703
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Entity Type | Individual
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Provider Name | ERIC MICHAEL BRADSHAW SR. D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 329 RHODE ISLAND AVE NE STE A
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City | WASHINGTON
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State | DC
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Zip | 20002-8129
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Country | US
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Telephone | 202-529-6468
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Fax | 202-529-3052
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Provider Business Mailing Address
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Address Line | 329 RHODE ISLAND AVE NE STE A
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City | WASHINGTON
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State | DC
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Zip | 20002-8129
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Country | US
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Telephone | 202-529-6468
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Fax | 202-529-3052
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN1000884
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 17975
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License Number State | MD
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