Individual
DR. BRANDON LEE GREENWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
410 NE WALDO RD, GAINESVILLE, FL 32641-5685
(352) 375-3790
(352) 375-3791
Mailing address
1302 RIVER ST, PALATKA, FL 32177-5042
(386) 328-8371
(386) 328-1519
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 19737
FL
Other
Enumeration date
06/11/2012
Last updated
10/29/2013
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