Individual
MR. CYRUS BRANDEN FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PC
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6001
(505) 368-6360
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
(505) 368-6360
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7020
CO
Other
Enumeration date
02/06/2007
Last updated
04/17/2019
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