Organization
MARY J. BRANNOCK DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID W BRANNOCK (OFICE MANAGER)
(480) 922-0600
Entity
Organization
Contact information
Practice address
13430 N SCOTTSDALE RD, #100, SCOTTSDALE, AZ 85254-4057
(480) 922-0600
(480) 922-0981
Mailing address
13430 N SCOTTSDALE RD, #100, SCOTTSDALE, AZ 85254-4057
(480) 922-0600
(480) 922-0981
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4818
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992874689
DENTAL
AZ
Enumeration date
09/19/2007
Last updated
09/19/2007
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