Individual
BRANNON W HEAPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
2971 CORPORATE PARK DR, OPELIKA, AL 36801-7283
(334) 749-3436
(334) 749-3223
Mailing address
1305 PHYSICIANS DR, WILMINGTON, NC 28401-7352
(910) 762-2618
(910) 763-5173
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D.5941
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2012
Last updated
05/29/2019
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