Individual
DR. MARK D BRANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11110 N TATUM BLVD STE H102, PHOENIX, AZ 85028-1607
(602) 354-7607
(602) 354-7609
Mailing address
11110 N TATUM BLVD STE H102, PHOENIX, AZ 85028-1607
(602) 354-7607
(602) 354-7609
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D02856
AZ
Other
Enumeration date
11/29/2006
Last updated
04/09/2020
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