Individual
DR. BRADY MICHAEL THOMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1624 N 200 E STE 120, NORTH LOGAN, UT 84341-3141
(435) 752-1320
(435) 752-1320
Mailing address
1624 N 200 E STE 120, NORTH LOGAN, UT 84341-3141
(435) 752-1320
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
4804772-9921
UT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4804772-9921
UT
Other
Enumeration date
11/01/2005
Last updated
01/03/2022
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