Organization
WINDSTONE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARAD BRADDY D.D.S. (MEMBER)
(662) 874-5917
Entity
Organization
Contact information
Practice address
4824 GOODMAN RD, OLIVE BRANCH, MS 38654-7950
(662) 874-5917
(662) 874-5998
Mailing address
4824 GOODMAN RD, OLIVE BRANCH, MS 38654-7950
(662) 874-5917
(662) 874-5998
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3341-05
MS
Other
Enumeration date
02/15/2013
Last updated
02/15/2013
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