Individual
DR. BRANDON KEITH BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
202 N MAPLE ST, ELDON, MO 65026-1776
(573) 392-5213
(573) 392-5213
Mailing address
23 MOCKINGBIRD RD, LAKE OZARK, MO 65049-7108
(314) 704-0881
(573) 392-5213
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2009013178
MO
Other
Enumeration date
03/09/2009
Last updated
09/05/2013
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