Provider Demographics
NPI:1205381811
Name:BRADLEY G SHERN, DMD
Entity Type:Organization
Organization Name:BRADLEY G SHERN, DMD
Other - Org Name:MOUNTAIN VIEW DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHERN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:509-838-6261
Mailing Address - Street 1:2807 S STONE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4904
Mailing Address - Country:US
Mailing Address - Phone:509-838-6261
Mailing Address - Fax:509-838-4482
Practice Address - Street 1:2807 S STONE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4904
Practice Address - Country:US
Practice Address - Phone:509-838-6261
Practice Address - Fax:509-838-4482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty