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General NPI Number Information
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NPI Number | 1396986006
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Entity Type | Individual
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Provider Name | BRADLEY R GILMER DDS
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Gender | Male
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 4030 EASTON STA STE 250
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City | COLUMBUS
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State | OH
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Zip | 43219-7007
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Country | US
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Telephone | 614-414-0111
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Fax | 614-414-7841
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Provider Business Mailing Address
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Address Line | 4030 EASTON STA STE 250
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City | COLUMBUS
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State | OH
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Zip | 43219-7007
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Country | US
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Telephone | 614-414-0111
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Fax | 614-414-7841
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 021779
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License Number State | OH
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