Organization
FIRESTONE PEDIATRIC DENTISTRY AND ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW F BRADY DDS (OWNER)
(757) 462-6602
Entity
Organization
Contact information
Practice address
7613 ESTHER CIR, FREDERICK, CO 80504-5881
(720) 638-6114
Mailing address
8301 COLORADO BLVD, SUITE 200, FIRESTONE, CO 80504
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
CO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
CO
Other
Enumeration date
04/09/2015
Last updated
06/10/2024
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