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NPI 1962691311

NPI 1962691311 : BRADLEY K. BRITTAIN, DDS, PC : SCOTTSDALE, AZ

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General NPI Number Information
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    NPI Number           |    1962691311
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    Entity Type          |    Organization 
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    Legal Business Name  |    BRADLEY K. BRITTAIN, DDS, PC 
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Dates
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    Enumeration Date     |    10/22/2007
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    Last Update Date     |    10/22/2007
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Provider Practice Location Address
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    Address Line         |    7449 E OSBORN RD SUITE 4
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    City                 |    SCOTTSDALE
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    State                |    AZ
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    Zip                  |    85251-6448
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    Country              |    US
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    Telephone            |    480-945-3723
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    Fax                  |    480-945-2067
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Provider Business Mailing Address
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    Address Line         |    7449 E OSBORN RD SUITE 4
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    City                 |    SCOTTSDALE
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    State                |    AZ
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    Zip                  |    85251-6448
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    Country              |    US
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    Telephone            |    480-945-3723
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    Fax                  |    480-945-2067
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Authorized Official
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    Title or Position    |    OWNER/PRESIDENT
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    Name                 |    DR. BRAD  BRITTAIN 
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    Credential           |    DDS
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    Telephone            |    480-945-3723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    D5890
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    License Number State |    AZ
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