NPI 1003346917

Brady Todd Petersen, DMDMS

Practitioner Orthodontics and Dentofacial Orthopedics Dentistry Las Vegas, NV

Practice location

Address: 6425 S Durango Dr STE 120, Las Vegas, NV 89113-7113
Phone: (702) 757-5355

Registered specialties

Orthodontics and Dentofacial Orthopedics Dentistry Primary

Dental Providers Taxonomy 1223X0400X Licence S3-366 (NV)

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Registry record

NPI: 1003346917
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Jun 2017
Record last updated: 30 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.