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1992320915
BRADY CARLEN
POCATELLO, ID
NPI
1992320915
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: ID D-5152)
Enumeration Date
2020-06-15
Last Update Date
2020-06-15
Business Address
BRADY CARLEN DDS
921 S 8TH AVE STOP 8088
POCATELLO, ID 83209-0002
Phone number: 208-282-6000
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Mailing Address
BRADY CARLEN DDS
427 PHEASANT RIDGE DR APT D
CHUBBUCK, ID 83202-1751
Phone number: 435-512-6288
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