Individual
DR. MARTHA BRYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
664 MAHONING ST, MILTON, PA 17847-2240
(570) 742-8231
(570) 742-4980
Mailing address
664 MAHONING ST, MILTON, PA 17847-2240
(570) 742-8231
(570) 742-4980
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS024906L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010416430001
MEDICAL ASSISTANCE
PA
01
—
735573
UNITED CONCORDIA
PA
Enumeration date
07/16/2006
Last updated
07/08/2007
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