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General NPI Number Information
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NPI Number | 1043416753
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Entity Type | Individual
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Provider Name | BRANDON COLE HEDGECOCK D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 5920 W WILLIAM CANNON DR BLDG 6 SUITE 200
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City | AUSTIN
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State | TX
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Zip | 78749-1902
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Country | US
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Telephone | 512-633-0055
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Fax |
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Provider Business Mailing Address
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Address Line | 7500 SHADOWRIDGE RUN #26
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City | AUSTIN
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State | TX
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Zip | 78749-4275
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Country | US
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Telephone | 512-633-0055
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 26159
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License Number State | TX
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