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General NPI Number Information
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NPI Number | 1598454092
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Entity Type | Individual
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Provider Name | KAYLEE BRADFORD DMD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2023
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 117 VILLAGE RD NE STE H
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City | LELAND
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State | NC
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Zip | 28451-3900
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Country | US
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Telephone | 910-371-5664
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Fax |
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Provider Business Mailing Address
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Address Line | 560G PARKERTOWN RD
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City | FOUR OAKS
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State | NC
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Zip | 27524-8907
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Country | US
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Telephone | 919-802-1140
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Fax |
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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 | 14267
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License Number State | NC
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