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Individual

MRS. BRANDI KAYE KANER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
21 HERITAGE DR, SUITE 100, BOURBONNAIS, IL 60914-1465
(815) 936-3232
(815) 936-3236
Mailing address
1278 HARTLEY AVE, BOURBONNAIS, IL 60914-1135
(815) 304-4956

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
K560-0718-2640
IL

Other

Enumeration date
04/09/2008
Last updated
04/09/2008
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