Individual
DR. JOHN BRANDEBURA JR.
Active
Individual
DR. JOHN BRANDEBURA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2226
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000812852
UNITED CONCORDIA (INDVL)
—
01
—
000861460
UNITED CONCORDIA (GRP)
—
05
—
100026580A
—
OK
05
—
127321679
—
AR
01
—
1548288244
GROUP NPI
—
01
—
5C081
MEDICARE - GROUP NUMBER
AR
Enumeration date
03/24/2006
Last updated
04/28/2009
Update your record
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