Individual
DR. EDWARD C BRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
447 LAKE AVENUE, ST JAMES, NY 11780
(631) 584-4395
(631) 584-4398
Mailing address
447 LAKE AVENUE, ST JAMES, NY 11780
(631) 584-4395
(631) 584-4398
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
043007
NY
Other
Enumeration date
07/23/2008
Last updated
07/23/2008
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