Organization
BRANDON C. PAYNE D.D.S., M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON C PAYNE MD, DDS (PRESIDENT)
(719) 542-4546
Entity
Organization
Contact information
Practice address
4728 EAGLERIDGE CIR STE 110, PUEBLO, CO 81008-2196
(719) 542-4546
(719) 542-4548
Mailing address
4728 EAGLERIDGE CIR STE 110, PUEBLO, CO 81008-2196
(719) 542-4546
(719) 542-4548
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10136
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33987220
—
CO
Enumeration date
05/18/2007
Last updated
11/10/2024
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