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General NPI Number Information
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NPI Number | 1386191401
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Entity Type | Individual
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Provider Name | BRANSON LYLE BILLINGS D.D.S., M.S.D.
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Gender | Male
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 8600 TOM WATSON PKWY., STE. 101
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City | PARKVILLE
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State | MO
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Zip | 64152
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Country | US
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Telephone | 816-741-9007
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Fax | 816-741-6984
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Provider Business Mailing Address
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Address Line | 8600 TOM WATSON PKWY., STE. 101
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City | PARKVILLE
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State | MO
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Zip | 64152
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Country | US
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Telephone | 816-741-9007
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Fax | 816-741-6984
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2015000293
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License Number State | MO
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