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BRANDON LEE COPPERSMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1720 CONGRESS AVE, OSHKOSH, WI 54901-7701
(209) 235-3251
Mailing address
1801 W WISCONSIN AVE, MILWAUKEE, WI 53233-2186
(414) 288-6790

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6001066-15
WI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/05/2022
Last updated
08/15/2022
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