Organization
BRANDI PRATHER DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDI PRATHER DMD (OWNER/ DENTIST)
(606) 679-1333
Entity
Organization
Contact information
Practice address
47 SARAHS LN, SOMERSET, KY 42503-2789
(606) 679-1333
Mailing address
PO BOX 224, SOMERSET, KY 42502-0224
(606) 679-1333
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8103
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60003886
—
KY
Enumeration date
11/02/2011
Last updated
11/02/2011
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