Individual
DR. TIFFANY A. BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
100 NICOLLS RD, ROCKLAND HALL, ROOM 114, STONY BROOK, NY 11794-8701
(631) 632-3181
(631) 632-8717
Mailing address
7950 NW 53RD ST, SUITE 200, MIAMI, FL 33166-4653
(954) 417-1337
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN21459
FL
1223P0221X
Pediatric Dentistry
Primary
DN21459
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2013
Last updated
12/03/2015
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