Organization
BRANNON DENTAL ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL S. BRANNON DDS (PARTNER)
(304) 927-2775
Entity
Organization
Contact information
Practice address
350 HOSPITAL DR, SPENCER, WV 25276-1049
(304) 927-2775
(304) 927-2777
Mailing address
350 HOSPITAL DR, SPENCER, WV 25276-1049
(304) 927-2775
(304) 927-2777
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
WV2812
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810005897
—
WV
Enumeration date
09/20/2006
Last updated
01/04/2016
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