Provider Demographics
NPI:1346369501
Name:TRATTNER, BRADLEY ALLAN (DDS)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:ALLAN
Last Name:TRATTNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 RESERVOIR CIR
Mailing Address - Street 2:#102
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-6324
Mailing Address - Country:US
Mailing Address - Phone:410-653-2020
Mailing Address - Fax:410-486-6617
Practice Address - Street 1:8 RESERVOIR CIR
Practice Address - Street 2:#102
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-6324
Practice Address - Country:US
Practice Address - Phone:410-653-2020
Practice Address - Fax:410-486-6617
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101461223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics