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Individual

DR. JASON WAYNE BRADY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
3967 E LEAH CT, APT 101, GILBERT, AZ 85234-0019
(858) 752-4622
(866) 329-8262
Mailing address
3967 E LEAH CT, APT 101, GILBERT, AZ 85234-0019
(858) 752-4622
(866) 329-8262

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
D008375
AZ
1223D0004X
Dental Anesthesiology
30599
TX
1223D0004X
Dental Anesthesiology
3827-15
MS
1223D0004X
Dental Anesthesiology
60944
CA
1223D0004X
Dental Anesthesiology
Primary
D008375
AZ

Other

Enumeration date
06/21/2012
Last updated
09/03/2015
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