Individual
BRANDON S KVIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2900 DOOLITTLE DR BLDG 6000, ELLSWORTH AFB, SD 57706-4821
(605) 385-3657
Mailing address
2900 DOOLITTLE DR BLDG 6000, ELLSWORTH AFB, SD 57706-4821
(605) 385-3657
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13083
MN
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
04/23/2012
Last updated
09/20/2013
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