Provider Demographics
NPI:1053668038
Name:BRANHAM, WILLIAM HAROLD (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HAROLD
Last Name:BRANHAM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 NEWBERRY DR
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-7702
Mailing Address - Country:US
Mailing Address - Phone:919-563-9955
Mailing Address - Fax:
Practice Address - Street 1:1158 NEWBERRY DR
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-7702
Practice Address - Country:US
Practice Address - Phone:919-563-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3652122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist