| NPI | 1043557085 |
|---|---|
| Former Legal Business Name | DRS. JOE BRADDY & SIMMONS |
| Entity Type | Organization |
| Authorized Contact | JARAD BRADDY Member 662-393-0781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MS 3341-05) |
| Enumeration Date | 2013-01-10 |
| Last Update Date | 2016-01-28 |