Provider Demographics
NPI:1063662294
Name:KELLER, BRADY S (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRADY
Middle Name:S
Last Name:KELLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:1601 ZIMMERMAN TRL STE 1
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-7654
Mailing Address - Country:US
Mailing Address - Phone:406-248-3303
Mailing Address - Fax:406-248-3939
Practice Address - Street 1:1690 RIMROCK RD STE C
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-0700
Practice Address - Country:US
Practice Address - Phone:406-248-3303
Practice Address - Fax:406-248-3939
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT23881223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry