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General NPI Number Information
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NPI Number | 1346512308
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Entity Type | Individual
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Provider Name | STEVEN BRANBERG D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2012
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Last Update Date | 12/27/2016
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Provider Practice Location Address
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Address Line | 5301 COLLEYVILLE BLVD 110
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City | COLLEYVILLE
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State | TX
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Zip | 76034-5870
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Country | US
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Telephone | 817-498-3331
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Fax | 817-479-0072
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Provider Business Mailing Address
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Address Line | 3324 MCKINNEY AVE 614
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City | DALLAS
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State | TX
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Zip | 75204-2364
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Country | US
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Telephone | 310-892-0297
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 27565
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License Number State | TX
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