Individual
BRANDON MICHAEL LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
959 BRUSH HOLLOW RD STE 102, WESTBURY, NY 11590-1711
(516) 333-5900
Mailing address
959 BRUSH HOLLOW RD STE 102, WESTBURY, NY 11590-1711
(516) 333-5900
(516) 333-5868
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
063971
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2018
Last updated
07/17/2024
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