Individual
DR. OTIS ALEXANDER BRANNIGAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
DEPT OF THE ARMY, DENTAL ACTIVITY STOP B, 2817 REILLY RD, MCDS-NA-B, FORT BRAGG, NC 28310-0001
(910) 396-5610
(910) 396-7017
Mailing address
DEPT OF THE ARMY, DENTAL ACTIVITY STOP B, 2817 REILLY RD, MCDS-NA-B, FORT BRAGG, NC 28310-0001
(910) 396-5610
(910) 396-7017
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
497
VI
Other
Enumeration date
01/23/2006
Last updated
03/07/2023
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