Provider Demographics
NPI:1609280080
Name:BRADLEY C. RULE, DDS, P.C.
Entity Type:Organization
Organization Name:BRADLEY C. RULE, DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:RULE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-662-7717
Mailing Address - Street 1:6475 WASHINGTON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-4404
Mailing Address - Country:US
Mailing Address - Phone:847-662-7717
Mailing Address - Fax:847-662-7790
Practice Address - Street 1:6475 WASHINGTON ST STE 101
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-4404
Practice Address - Country:US
Practice Address - Phone:847-662-7717
Practice Address - Fax:847-662-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0209851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty