Individual
MR. CARL EDWARD BRANYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
CLINICA SANTA MARIA 730 GRANDVILLE AVE S.W., DENTAL DEPARTMENT, GRAND RAPIDS, MI 49503-4502
(616) 913-8401
(616) 742-1322
Mailing address
CLINICA SANTA MARIA 730 GRANDVILLE AVE S.W., DENTAL DEPARTMENT, GRAND RAPIDS, MI 49503-4502
(616) 913-8401
(616) 742-1322
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901008455
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124461490
—
MI
Enumeration date
02/14/2008
Last updated
02/14/2008
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