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Organization

BRANDON LEBECK DENTAL CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRANDON LEBECK DDS (PRESIDENT)
(408) 476-5459
Entity
Organization

Contact information

Practice address
801 RIVER DR, FORT BRAGG, CA 95437-5404
(707) 964-8080
Mailing address
801 RIVER DR, FORT BRAGG, CA 95437-5404
(707) 964-8080

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
12/16/2024
Last updated
12/16/2024
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