Organization
BRANDON PRIOR DMD LLC
Active
Other names
100 West Dental
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON PRIOR DMD (OWNER/DENTIST)
(618) 514-2520
Entity
Organization
Contact information
Practice address
13759 MANCHESTER RD, BALLWIN, MO 63011-6301
(618) 514-2520
Mailing address
1012 ARLINGTON DR, COLUMBIA, IL 62236-1513
(618) 514-2520
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/03/2019
Last updated
05/03/2019
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