Individual
BRANDON DIETER CANAZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
7115 GUILFORD DR STE 101, FREDERICK, MD 21704-5234
(240) 379-1550
Mailing address
6949 EXETER CT APT 103, FREDERICK, MD 21703-6466
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7557
MD
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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