Individual
DR. MICHAEL STEPHEN BRANDON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3301 BERRYWOOD DR, COLUMBIA, MO 65201-6517
(573) 884-6253
(573) 875-9150
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 882-3974
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4281
SC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2017017086
MO
Other
Enumeration date
03/21/2007
Last updated
05/09/2019
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