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General NPI Number Information
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NPI Number | 1669719480
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Entity Type | Individual
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Provider Name | BRADLEE LEVINE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/14/2013
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Last Update Date | 12/21/2016
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Provider Practice Location Address
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Address Line | 7811 MONTROSE RD. SUITE 300
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City | POTOMAC
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State | MD
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Zip | 20854
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Country | US
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Telephone | 301-530-3717
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Fax | 301-417-8170
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Provider Business Mailing Address
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Address Line | 7811 MONTROSE RD. SUITE 300
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City | POTOMAC
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State | MD
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Zip | 20854
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Country | US
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Telephone | 301-530-3717
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Fax | 301-417-8170
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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 | 83-17
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License Number State | MD
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