Individual
DR. BRANDON LEWIS POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1101 GREAT FALLS CT, STE 102, KNIGHTDALE, NC 27545
(919) 415-1855
(919) 415-1849
Mailing address
1101 GREAT FALLS CT, STE 102, KNIGHTDALE, NC 27545
(919) 415-1855
(919) 415-1849
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8021
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366529372
—
NC
01
—
9021T
BLUE CROSS BLUE SHIELD NC
—
Enumeration date
11/01/2006
Last updated
11/26/2024
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