Provider Demographics
NPI:1871545970
Name:LEMBKE, BRADLEY DEAN (DDS)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:DEAN
Last Name:LEMBKE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-0189
Mailing Address - Country:US
Mailing Address - Phone:952-934-3383
Mailing Address - Fax:952-934-6668
Practice Address - Street 1:480 W 78TH ST
Practice Address - Street 2:SUITE #116
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-4527
Practice Address - Country:US
Practice Address - Phone:952-934-3383
Practice Address - Fax:952-934-6668
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice