Healthcare Provider Details

I. General information

NPI: 1407942428
Provider Name (Legal Business Name): DAVID JAMES BRAND D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 CARMICHAEL RD SUITE 205
MONTGOMERY AL
36106-3613
US

IV. Provider business mailing address

4001 CARMICHAEL RD SUITE 205
MONTGOMERY AL
36106-3613
US

V. Phone/Fax

Practice location:
  • Phone: 334-260-8166
  • Fax: 334-260-8321
Mailing address:
  • Phone: 334-260-8166
  • Fax: 334-260-8321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number3027
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: