Provider Demographics
NPI:1972683266
Name:BRADLEY, CYNTHIA S (DMD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:S
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 SILVERSIDE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4520
Mailing Address - Country:US
Mailing Address - Phone:302-475-0100
Mailing Address - Fax:302-475-5550
Practice Address - Street 1:2415 SILVERSIDE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4520
Practice Address - Country:US
Practice Address - Phone:302-475-0100
Practice Address - Fax:302-475-5550
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE10441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice