# KELLI BRADY DDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548507643
- **Authorized official:** DR. KELLI BRADY D.D.S. (OWNER/DENTIST)
- **Authorized official phone:** (201) 768-5553

## Contact information

- **Practice address:** 180 OLD TAPPAN RD, BLDG 6, OLD TAPPAN, NJ 07675-7052
- **Practice address phone:** (201) 768-5553
- **Practice address fax:** (201) 768-7601
- **Mailing address:** 180 OLD TAPPAN RD, BLDG 6, OLD TAPPAN, NJ 07675-7052
- **Mailing address phone:** (201) 768-5553
- **Mailing address fax:** (201) 768-7601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22D102398600 | NJ | Yes |

## Other

- **Enumeration date:** 01/09/2013
- **Last updated:** 01/09/2013