Individual
DR. BRENDAN WITHYCOMBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
360 PEAK ONE DR STE 325, FRISCO, CO 80443-5948
(970) 668-4055
Mailing address
1612 MOUNT EVANS DR, LEADVILLE, CO 80461-3720
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN.00205722
CO
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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