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General NPI Number Information
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NPI Number | 1497001002
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Entity Type | Organization
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Legal Business Name | DUBLIN FAMILY DENTISTRY, P.C.
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 08/01/2012
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Provider Practice Location Address
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Address Line | 117 N GRAFTON ST
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City | DUBLIN
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State | TX
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Zip | 76446-1907
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Country | US
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Telephone | 254-445-2442
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Fax | 254-445-4779
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Provider Business Mailing Address
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Address Line | 117 N GRAFTON ST
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City | DUBLIN
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State | TX
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Zip | 76446-1907
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Country | US
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Telephone | 254-445-2442
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Fax | 254-445-4779
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | DR. BRANDI BURGAN
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Credential | DDS
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Telephone | 254-445-2442
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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 | 25447
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License Number State | TX
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