Healthcare Provider Details

I. General information

NPI: 1902299233
Provider Name (Legal Business Name): BRADY HALL MOSHER DMD, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 N DUKE ST STE 28
DURHAM NC
27704-1769
US

IV. Provider business mailing address

3600 N DUKE ST STE 28
DURHAM NC
27704-1769
US

V. Phone/Fax

Practice location:
  • Phone: 984-288-0872
  • Fax:
Mailing address:
  • Phone: 984-288-0872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14211
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD012687
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: