Individual
DR. BRADY MICHAEL ANDVIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
303 MAIN ST NW, ELK RIVER, MN 55330-1531
(763) 441-9181
Mailing address
930 37TH AVE S, MOORHEAD, MN 56560-6130
(218) 329-1972
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13082
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2012
Last updated
05/25/2012
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