Provider Demographics
NPI:1043247554
Name:RICHTER, BRANTON J (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRANTON
Middle Name:J
Last Name:RICHTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 E 600 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-4219
Mailing Address - Country:US
Mailing Address - Phone:801-472-1707
Mailing Address - Fax:
Practice Address - Street 1:3300 N RUNNING CREEK WAY
Practice Address - Street 2:BLDG F, STE 101
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043
Practice Address - Country:US
Practice Address - Phone:801-766-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT59398681223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry