Search › Indiana › 122300000X
Bradley Wisowaty
NPI 1306229562 · on the registry since 2015 · sole proprietor
Practice
- Address
- 809 Wall St Ste A
Valparaiso, IN 46383 - Phone
- (219) 464-9681
- Organisation at this address
- Pediatric Dentistry Of Northwest Indiana Pc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Also registered as
- 1223G0001X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-11-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana