Dr. Bradley Isom
Dentist in Knoxville, TN. Individual provider (NPI-1).
NPI number1356757462
StatusActive
Last updated in NPPESSep 18, 2024
Details
- NPI
- 1356757462
- Entity type
- Individual (NPI-1)
- Name
- Dr. Bradley Isom
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 9, 2014
- Certification date
- Sep 18, 2024
- Last updated
- Sep 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D008951 | AZ | Yes |
Practice location
4329 Ball Camp PikeKnoxville, TN 37921-3313
Phone 865-521-7707
Mailing address
4329 Ball Camp PikeKnoxville, TN 37921-3313
Phone 865-521-7707
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