Kelli Brady DDS LLC
Dentist in Old Tappan, NJ. Organization (NPI-2).
NPI number1548507643
StatusActive
Last updated in NPPESJan 9, 2013
Details
- NPI
- 1548507643
- Entity type
- Organization (NPI-2)
- Legal business name
- Kelli Brady DDS LLC
- Organization subpart
- No
- Enumeration date
- Jan 9, 2013
- Last updated
- Jan 9, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 22D102398600 | NJ | Yes |
Practice location
180 Old Tappan RdBldg 6
Old Tappan, NJ 07675-7052
Phone 201-768-5553 · Fax 201-768-7601
Mailing address
180 Old Tappan RdBldg 6
Old Tappan, NJ 07675-7052
Phone 201-768-5553 · Fax 201-768-7601
Authorized official
Kelli Brady
Owner/Dentist
2017685553
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