Individual
DR. BRANDON ERIC DEVITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
20 MEDICAL CAMPUS DR, SUITE 201, SUPPLY, NC 28462-4096
(910) 755-6788
(910) 755-6789
Mailing address
20 MEDICAL CAMPUS DR, SUITE 201, SUPPLY, NC 28462-4096
(910) 755-6788
(910) 755-6789
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7423
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5900372
—
NC
Enumeration date
09/25/2006
Last updated
08/29/2012
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