Basic Information
Provider Information
NPI: 1396126421
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANCE
FirstName: BRADY
MiddleName: STUART
NamePrefix: DR.
NameSuffix:  
Credential: D.D.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 UNIVERSITY AVE
Address2: STE 200
City: DES MOINES
State: IA
PostalCode: 503142343
CountryCode: US
TelephoneNumber: 5152481447
FaxNumber: 5152481440
Practice Location
Address1: 2353 SE 14TH ST
Address2:  
City: DES MOINES
State: IA
PostalCode: 503201109
CountryCode: US
TelephoneNumber: 5152481470
FaxNumber: 5152481474
Other Information
ProviderEnumerationDate: 06/15/2015
LastUpdateDate: 08/10/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001XDDS-09217IAY Dental ProvidersDentistGeneral Practice

No ID Information.


Home