Individual
BRANDI J DIMMITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
110 S VISITING EAGLE ST, NIOBRARA, NE 68760-7201
(402) 857-2300
Mailing address
110 S VISITING EAGLE ST, NIOBRARA, NE 68760-7201
(402) 857-2300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6069
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025439300
—
NE
Enumeration date
12/12/2006
Last updated
01/21/2016
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