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DR. KERRY REDDING BRANTLY D.D.S.

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1891800942

Individual Registrant:
DR. KERRY REDDING BRANTLY D.D.S.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
113 LIELMANIS AVE  HURLBURT FIELD, FL 32544-5613 US
Tel: 850-881-2337  Fax: 850-881-2323

Contact information for business:
113 LIELMANIS AVE  HURLBURT FIELD, FL 32544-5613 US
Tel: 850-881-2337  Fax: 850-881-2323

Registration Information:
NPI: 1891800942
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
MI2901019216

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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