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General NPI Number Information
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NPI Number | 1225924780
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Entity Type | Individual
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Provider Name | BRANDON DOUGLAS SVOBODA DDS
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Gender | Male
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 827 S HIGHLAND ST
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City | WILLIAMSBURG
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State | IA
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Zip | 52361-9333
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Country | US
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Telephone | 319-668-9808
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 QUARRY LN APT 204
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City | CORALVILLE
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State | IA
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Zip | 52241-2224
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Country | US
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Telephone | 507-227-0807
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS-10364
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License Number State | IA
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