Provider Demographics
NPI:1740403138
Name:BRADLEY T. PIOTROWSKI, DDS, MSD, LLC
Entity Type:Organization
Organization Name:BRADLEY T. PIOTROWSKI, DDS, MSD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PIOTROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-263-6003
Mailing Address - Street 1:1044 CASTELLO DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-8901
Mailing Address - Country:US
Mailing Address - Phone:239-263-6003
Mailing Address - Fax:239-263-2579
Practice Address - Street 1:1044 CASTELLO DR
Practice Address - Street 2:SUITE 202
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-8901
Practice Address - Country:US
Practice Address - Phone:239-263-6003
Practice Address - Fax:239-263-2579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN155841223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty