| Organization Name: | BRADFORD L PICOT, DDS, P.A. |
| NPI Number: | 1003048752 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRADFORD LEE PICOT (OWNER/DENTIST) |
| Mailing Address: | 1520 South Blvd Suite 110 Charlotte |
| State: | NC US |
| Postal Code: | 282034786 |
| Phone Number: | 7043358266 |
| Fax Number: | 7043358267 |
| NPI Enumeration Date: | 08/13/2009 |
| NPI Last Update Date: | 08/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | 8158 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |