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Organization
BRADY NIELSEN DDS, INC.
Active
Organization
BRADY NIELSEN DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADY NIELSEN DDS (PRESIDENT)
(310) 883-5017
Entity
Organization
Contact information
Practice address
675 CAMINO DE LOS MARES STE 303, SAN CLEMENTE, CA 92673-2837
(949) 627-0230
(949) 627-0370
Mailing address
675 CAMINO DE LOS MARES STE 303, SAN CLEMENTE, CA 92673-2837
(949) 627-0230
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/04/2021
Last updated
03/04/2021
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