Individual
DR. BRANDON CHARLES SHAMBLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0026091
TX
1223P0221X
Pediatric Dentistry
Primary
0026091
TX
Other
Enumeration date
01/04/2011
Last updated
11/29/2012
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