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General NPI Number Information
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NPI Number | 1487029112
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Entity Type | Individual
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Provider Name | BRANDON ANGUS DDS
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Gender | Male
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 131 STANLEY AVE STE 201
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City | ESTES PARK
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State | CO
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Zip | 80517
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Country | US
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Telephone | 720-220-1161
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Fax |
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Provider Business Mailing Address
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Address Line | 131 STANLEY AVE STE 201
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City | ESTES PARK
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State | CO
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Zip | 80517-6356
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Country | US
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Telephone | 720-220-1161
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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 | 10069548-9922
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 202706
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License Number State | CO
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