Organization
THOMSON ORTHODONTICS
Active
Organization
THOMSON ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADY THOMSON D.D.S. (OWNER/ORTHODONTIST)
(435) 752-1320
Entity
Organization
Contact information
Practice address
1445 N 400 E STE 3, LOGAN, UT 84341-7564
(435) 752-1320
(435) 750-6432
Mailing address
1445 N 400 E STE 3, LOGAN, UT 84341-7564
(435) 752-1320
(435) 750-6432
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4804772
UT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
8041458
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821130253
INDIVIDUAL NPI
UT
01
—
1912998725
INDIVIDUAL NPI
UT
Enumeration date
09/08/2016
Last updated
09/08/2016
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