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General NPI Number Information
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NPI Number | 1376725499
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Entity Type | Individual
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Provider Name | DANIEL THOMAS BRADY DDS
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Gender | Male
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 16410 SMOKEY POINT BLVD SUITE 103
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City | ARLINGTON
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State | WA
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Zip | 98223-8415
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Country | US
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Telephone | 360-658-8822
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Fax | 360-659-1275
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Provider Business Mailing Address
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Address Line | 11705 WILMINGTON WAY
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City | MUKILTEO
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State | WA
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Zip | 98275-6012
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Country | US
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Telephone | 425-953-6476
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Fax | 360-659-1275
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DE 60214391
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License Number State | WA
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