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Organization

MARTHA JO BRAID DMD LLC

Active
Parent organization
MARTHA JO BRAID DMD LLC
Other names
Dental Care for Kids
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARTHA JO BRAID DMD LLC
Authorized official
PAM HARDIEK (INSURANCE/CREDENTIALING)
(210) 540-5100
Entity
Organization

Contact information

Practice address
2801-7 CIVIC CIRCLE BLVD, MARION, IL 62959
(618) 998-9868
(618) 998-9870
Mailing address
2801-7 CIVIC CIRCLE BLVD, MARION, IL 62959
(618) 998-9868
(618) 998-9870

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
09/09/2008
Last updated
09/09/2008
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