Individual
DR. LEAH NICOLE BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
600 E MAIN ST, SUITE 2, MANDAN, ND 58554-3536
(701) 667-1933
(701) 667-2115
Mailing address
600 E MAIN ST, SUITE 2, MANDAN, ND 58554-3536
(701) 667-1933
(701) 667-2115
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2070
ND
1223G0001X
General Practice Dentistry
2070
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457027
—
ND
Enumeration date
07/15/2010
Last updated
12/16/2015
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