Individual provider · NPI-1

Colby Trenton Bradford, D.M.D.

Dentist · Palm Beach Gardens, FL

NPI number1831769058
StatusActive
Last updated in NPPESOct 23, 2024

Details

NPI
1831769058
Entity type
Individual (NPI-1)
Name
Colby Trenton Bradford
Credential
D.M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 29, 2021
Certification date
Oct 23, 2024
Last updated
Oct 23, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist26182FLYes
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics26182FL

Practice location

11380 Prosperity Farms Rd Ste 117
Palm Beach Gardens, FL 33410-3464

Phone 561-694-3006

Mailing address

12812 South Shore Drive
Palm Beach Gardens, FL 33410

Phone 561-339-9948

Other practice locations

1151 Sw 30th St Ste C
Palm City, FL 34990-2985

Phone 561-694-3006

6045 Hagen Ranch Rd Ste 2
Lake Worth, FL 33467-7251

Phone 561-694-3006

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dentist providers in Palm Beach Gardens, FL