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General NPI Number Information
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NPI Number | 1780946467
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Entity Type | Organization
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Legal Business Name | ROBERT M ALEXANDER DDS MS & BRANDON D MARTIN DDS MS A PC
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 06/08/2012
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Provider Practice Location Address
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Address Line | 6809 FIVE STAR BLVD STE 300
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City | ROCKLIN
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State | CA
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Zip | 95677-2687
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Country | US
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Telephone | 916-630-0306
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Fax |
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Provider Business Mailing Address
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Address Line | 6809 FIVE STAR BLVD STE 300
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City | ROCKLIN
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State | CA
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Zip | 95677-2687
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Country | US
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Telephone | 916-630-0306
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. BRANDON D MARTIN
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Credential | DDS, MS
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Telephone | 916-630-0306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 45549
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 56921
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License Number State | CA
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