Wisowaty, Bradley

Wisowaty, Bradley is an sole proprietor health care provider with primary practice located at 809 Wall St Ste A , Valparaiso IN 46383-2571. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. Wisowaty, Bradley can be contacted via phone (219) 464-9681.

Contact Information

Primary practice address
809 Wall St Ste A Valparaiso IN 46383-2571
Phone: (219) 464-9681
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 12012301A Indiana
Dental Providers / Dentist 122300000X 12012301A Indiana

Profile Details

NPI number 1306229562
LBN Legal business name Wisowaty, Bradley
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2015
Last updated Nov 27th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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