Individual
DR. BRADY BENJAMIN NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
880 HERITAGE PARK BLVD STE 220, LAYTON, UT 84041-5680
(801) 728-4688
Mailing address
3759 W 850 S, SYRACUSE, UT 84075-9807
(801) 686-7836
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10383844-9922
UT
Other
Enumeration date
06/09/2017
Last updated
06/09/2017
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