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General NPI Number Information
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NPI Number | 1154210573
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Entity Type | Organization
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Legal Business Name | M. BRANDON LANDRETH DMD PLLC
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 2630 TIMBER DR
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City | GARNER
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State | NC
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Zip | 27529-2571
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Country | US
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Telephone | 336-287-4607
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Fax |
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Provider Business Mailing Address
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Address Line | 215 NEW LONDONDALE DR
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City | CARY
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State | NC
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Zip | 27513-5615
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Country | US
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Telephone | 336-287-4607
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. MICHAEL BRANDON LANDRETH
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Credential | DMD
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Telephone | 919-342-8629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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