# MARK D BRANNON DDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brannon Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679836860
- **Authorized official:** DR. MARK BRANNON DDS (OWNER)
- **Authorized official phone:** (480) 563-0000

## Contact information

- **Practice address:** 21809 N SCOTTSDALE RD, C 105, SCOTTSDALE, AZ 85255-7440
- **Practice address phone:** (480) 563-0000
- **Practice address fax:** (480) 563-4445
- **Mailing address:** 21809 N SCOTTSDALE RD, C 105, SCOTTSDALE, AZ 85255-7440
- **Mailing address phone:** (480) 563-0000
- **Mailing address fax:** (480) 563-4445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/21/2012
- **Last updated:** 06/21/2012