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General NPI Number Information
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NPI Number | 1578793600
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Entity Type | Individual
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Provider Name | BRANDON JAY VOS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/23/2009
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | S DENTAL SCIENCE BLDG RM 435 UNIVERSITY OF IOWA COLLEGE OF DENTISTRY
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City | IOWA CITY
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State | IA
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Zip | 52246
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Country | US
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Telephone | 319-335-7469
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Fax |
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Provider Business Mailing Address
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Address Line | 855 BLUE SKY DR APT 302
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-9031
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Country | US
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Telephone | 641-891-2288
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 08650
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License Number State | IA
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