Individual
BRENDA LACY BRANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
856 N EASTON RD, GLENSIDE, PA 19038-3831
(215) 887-0122
(215) 887-0122
Mailing address
856 N EASTON RD, GLENSIDE, PA 19038-3831
(215) 887-0122
(215) 887-0122
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS026465L
PA
Other
Enumeration date
05/11/2007
Last updated
12/17/2008
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