Provider Demographics
NPI:1033674585
Name:BRADY ORTHODONTICS, PC
Entity Type:Organization
Organization Name:BRADY ORTHODONTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-363-2200
Mailing Address - Street 1:80 W WELSH POOL RD STE 203
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1233
Mailing Address - Country:US
Mailing Address - Phone:610-363-2200
Mailing Address - Fax:610-594-9360
Practice Address - Street 1:80 W WELSH POOL RD STE 203
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1233
Practice Address - Country:US
Practice Address - Phone:610-363-2200
Practice Address - Fax:610-594-9360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty