Individual
DR. BRANDON TRAMELL MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
111 N 12TH ST, SUITE 1105, TAMPA, FL 33602-3661
(813) 397-3632
Mailing address
1081 A1A BEACH BLVD, ST AUGUSTINE, FL 32080-6733
(904) 471-3291
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21070
FL
Other
Enumeration date
01/27/2015
Last updated
10/08/2015
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