MEDICARE: DR. AARON BEN BRADLEY DMD

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	122300000X	Dentist	DS045048	PA

General Provider Information

NPI Number	:	1922843697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON BEN BRADLEY DMD

Provider Business Mailing Address
First Line	:	471 HEPBURN ST
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-6122
Country	:	US
Telephone Number	:	570-567-5400
Fax Number	:

Provider Business Practice Location Address
First Line	:	471 HEPBURN ST
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-6122
Country	:	US
Telephone Number	:	570-567-5400
Fax Number	:

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

Provider Enumeration Date	:	06/26/2024
Last Update Date	:	06/01/2026

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