MEDICARE: BRADLEY WAYNE BARTEL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN8327	FL

General Provider Information

NPI Number	:	1558379537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY WAYNE BARTEL DDS

Provider Business Mailing Address
First Line	:	150 AVE A SE
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-6301
Country	:	US
Telephone Number	:	863-294-9200
Fax Number	:	863-294-1916

Provider Business Practice Location Address
First Line	:	150 AVE A SE
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-6301
Country	:	US
Telephone Number	:	863-294-9200
Fax Number	:	863-294-1916

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/08/2007

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Directions to “ BRADLEY WAYNE BARTEL DDS” Practice Location

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