Individual
DR. GLENN ANDREW BRANCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
104 TREMONT ST, SUITE 5, DUXBURY, MA 02332-4750
(781) 934-8101
(781) 934-8187
Mailing address
104 TREMONT ST, SUITE 5, DUXBURY, MA 02332-4750
(781) 934-8101
(781) 934-8187
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
21191
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA36031
HPHC
MA
01
—
X09281
BLUE CROSS BLUE SHIELD
MA
Enumeration date
07/25/2006
Last updated
04/19/2013
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