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1265527089
BRENT THOMAS BRADY
BOISE, ID
NPI
1265527089
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: ID d1698)
Enumeration Date
2006-10-04
Last Update Date
2007-07-08
Business Address
Dr. BRENT THOMAS BRADY dds
210 W MALLARD , SUITE E
BOISE, ID 83706
Phone number: 208-344-8363
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Mailing Address
Dr. BRENT THOMAS BRADY dds
210 W MALLARD , SUITE E
BOISE, ID 83706
Phone number: 208-344-8363
Copy
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