Provider Demographics
NPI:1972508109
Name:BRADY, TODD GEORGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:GEORGE
Last Name:BRADY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3091 COLLEGE PARK DR
Mailing Address - Street 2:STE 310
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8026
Mailing Address - Country:US
Mailing Address - Phone:936-321-2995
Mailing Address - Fax:936-271-3225
Practice Address - Street 1:3091 COLLEGE PARK DR
Practice Address - Street 2:STE 310
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8026
Practice Address - Country:US
Practice Address - Phone:936-321-2995
Practice Address - Fax:936-271-3225
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX129391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice