Provider Demographics
NPI:1700969029
Name:ALMOND, BRADLEY MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:MICHAEL
Last Name:ALMOND
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 S PUEBLO BLVD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005
Mailing Address - Country:US
Mailing Address - Phone:719-565-2274
Mailing Address - Fax:719-565-6829
Practice Address - Street 1:1221 S PUEBLO BLVD
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005
Practice Address - Country:US
Practice Address - Phone:719-565-2274
Practice Address - Fax:719-542-6435
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9199122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist