Individual
BRANDON MIHALICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
7455 E TANQUE VERDE RD, TUCSON, AZ 85715-3477
(520) 745-2454
Mailing address
7455 E TANQUE VERDE RD, TUCSON, AZ 85715-3477
(520) 745-2454
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30.027383
OH
122300000X
Dentist
D012728
AZ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
30.027383
OH
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D012728
AZ
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
35.150020
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
79644
AZ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/24/2021
Last updated
03/17/2026
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