Individual
DANICA BRANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1790 7TH ST E, SAINT PAUL, MN 55119-3419
(651) 735-0595
Mailing address
960 101ST AVE NE, BLAINE, MN 55434-2669
(612) 965-3096
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
H11617
MN
125J00000X
Dental Therapist
Primary
DT173
MN
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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