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Organization

LEAH BRADY, DDS, PC

Active
Other names
Ideal Image Dentistry & Spa
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEAH N BRADY DDS (DENTIST)
(701) 667-1933
Entity
Organization

Contact information

Practice address
1008 E MAIN ST, MANDAN, ND 58554-3762
(701) 667-1933
(701) 667-2115
Mailing address
1008 E MAIN ST, MANDAN, ND 58554-3762
(701) 667-2115

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2070
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40018
ND
Enumeration date
10/17/2011
Last updated
10/20/2011
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