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Individual

DR. BRANDON ROBERT MADDOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1100 RICKARD RD, SUITE B, SPRINGFIELD, IL 62704-6301
(217) 546-4738
Mailing address
1100 RICKARD RD, SUITE B, SPRINGFIELD, IL 62704-6301
(217) 546-4738

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019025561
IL

Other

Enumeration date
02/06/2007
Last updated
09/16/2023
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