Provider Demographics
NPI:1144996711
Name:ERRON S BRADY DMD PA
Entity type:Organization
Organization Name:ERRON S BRADY DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERRON
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-321-0414
Mailing Address - Street 1:11030 GOLF LINKS DR N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277
Mailing Address - Country:US
Mailing Address - Phone:704-321-0414
Mailing Address - Fax:704-321-0217
Practice Address - Street 1:11030 GOLF LINKS DR N
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277
Practice Address - Country:US
Practice Address - Phone:704-321-0414
Practice Address - Fax:704-321-0217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-23
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental