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BRADFORD B. LILES DMD PC NPI 1649670936


NPI Information

NPI: 1649670936
Provider Name: BRADFORD B. LILES, DMD, PC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
5721 HIGHWAY 90 STE A
THEODORE, AL
ZIP 36582
Phone: (251) 653-1300
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BRADFORD B. LILES, DMD, PC is a general practice dentist in Theodore, AL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. BRADFORD B. LILES, DMD, PC NPI is 1649670936. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5721 HIGHWAY 90 STE A
THEODORE, AL
ZIP 36582-601
Phone: (251) 653-1300
Fax: (251) 653-1242

The provider's authorized official is Bradford Bowen Liles .
The authorized official title is Owner/dentist and has the following contact phone number (251) 653-1300.

The enumeration date for this NPI number is 8/25/2014 and was last updated on 8/25/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice5762ALABAMAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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