Great Northern Dental Assoc PC

NPI #1013011139 in Escanaba, Michigan

Provider Information

NPI Number: 1013011139
Entity Type: Organization
Organization Name: Great Northern Dental Assoc PC
Primary Specialty: Dentist
Enumeration Date: Sep 11, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1100 1ST AVE NORTH
City: Escanaba
State: Michigan
ZIP Code: 49829
Phone: (906) 786-3814

Authorized Official

Name: DR. GARY W BRADLEY, DDS
Title: PRESIDENT
Phone: (906) 786-3814

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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