Organization
P BRADY FARR DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. P BRADY FARR DMD (PRESIDENT)
(256) 543-3303
Entity
Organization
Contact information
Practice address
817 A RIVERBEND DRIVE, GADSDEN, AL 35901-2556
(256) 543-3303
Mailing address
817 A RIVERBEND DRIVE, GADSDEN, AL 35901-2556
(256) 543-3303
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2850
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180670
UNITED CONCORDIA
PA
01
—
51092086
BLUECROSS BLUESHIELD
AL
Enumeration date
11/06/2006
Last updated
08/22/2020
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