Individual
DR. BRANDON W. FAIRBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
3300 N RUNNING CREEK WAY, BLDG F, SUITE 102, LEHI, UT 84003
(801) 766-4660
(801) 766-4661
Mailing address
3300 N RUNNING CREEK WAY, BLDG F, SUITE 102, LEHI, UT 84003
(801) 766-4660
(801) 766-4661
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5334209-9921
UT
Other
Enumeration date
10/11/2007
Last updated
10/11/2007
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