Individual
PATRICK BRADY
Active
Individual
PATRICK BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
19030503
IL
390200000X
Student in an Organized Health Care Education/Training Program
30408
IA
Other
Enumeration date
07/31/2014
Last updated
04/24/2024
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