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Individual

DR. BRANDON LEBECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
801 RIVER DR, FORT BRAGG, CA 95437-5404
(707) 964-8080
Mailing address
3500 LEE TERRACE CT, SAN JOSE, CA 95127-4373
(408) 476-5459

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
109077
CA

Other

Enumeration date
08/08/2023
Last updated
08/08/2023
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