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General NPI Number Information
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NPI Number | 1770997637
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Entity Type | Organization
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Legal Business Name | BRANDON CAMPBELL, DDS, PLLC
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 6350 W 92ND AVE
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City | WESTMINSTER
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State | CO
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Zip | 80031-2912
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Country | US
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Telephone | 720-877-1390
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Fax |
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Provider Business Mailing Address
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Address Line | 6350 W 92ND AVE
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City | WESTMINSTER
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State | CO
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Zip | 80031-2912
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Country | US
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Telephone | 720-877-1390
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRANDON CAMPBELL
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Credential | DDS
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Telephone | 720-877-1390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 201813
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License Number State | CO
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