Individual
BRETT JOSEPH CARRANZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
218 W 39TH ST, KEARNEY, NE 68845-2802
(402) 480-4466
Mailing address
218 W 39TH ST, KEARNEY, NE 68845-2802
(402) 480-4466
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6781
NE
1223P0221X
Pediatric Dentistry
Primary
6781
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6781
DENTAL LICENSE
NE
Enumeration date
07/29/2008
Last updated
12/03/2012
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