Individual
DR. MATTHEW BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7613 ESTHER CIR, FREDERICK, CO 80504-5881
(757) 462-6602
Mailing address
2381 ANTELOPE RIDGE TRL, PARKER, CO 80138-4235
(757) 462-6602
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D8112
OR
1223P0221X
Pediatric Dentistry
Primary
00201885
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61086541
—
CO
Enumeration date
01/27/2006
Last updated
05/24/2024
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