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General NPI Number Information
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NPI Number | 1679663207
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Entity Type | Individual
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Provider Name | BRANDON G. BENTZ MD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 711 N TAYLOR ST
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City | GUNNISON
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State | CO
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Zip | 81230-2296
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Country | US
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Telephone | 970-641-1456
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Fax | 970-641-4461
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Provider Business Mailing Address
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Address Line | 3800 SUMMITVIEW AVE
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City | YAKIMA
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State | WA
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Zip | 98902-2715
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Country | US
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Telephone | 509-248-7849
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Fax | 509-248-8291
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | G89294
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 60914678
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | DR.0070421
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License Number State | CO
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