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General NPI Number Information
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NPI Number | 1770568677
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Entity Type | Individual
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Provider Name | LESTER LAWRENCE BRANSON OD
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Gender | Male
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 320 MARKET ST
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City | DENTON
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State | MD
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Zip | 21629-1039
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Country | US
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Telephone | 410-479-0500
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Fax | 410-479-0877
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Provider Business Mailing Address
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Address Line | PO BOX 276
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City | DENTON
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State | MD
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Zip | 21629-0276
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Country | US
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Telephone | 410-479-2546
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Fax | 410-479-0877
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | MDTA0577
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License Number State | MD
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