Individual
DARA T BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
6226 14TH AVE, KENOSHA, WI 53143-4413
(262) 656-0044
Mailing address
625 57TH ST, SUITE 700, KENOSHA, WI 53140-4146
(262) 656-0044
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6848-16
WI
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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