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Individual

DR. GUNNER LANE BRANTLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
511 N RIDGEVIEW DR, WARRENSBURG, MO 64093-9336
(660) 747-9117
Mailing address
400 RIVERWALK TER STE 250, JENKS, OK 74037-5619
(918) 998-0996

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2024038491
MO
1223G0001X
General Practice Dentistry
7910
NE

Other

Enumeration date
06/07/2023
Last updated
10/02/2024
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