Provider Demographics
NPI:1073868766
Name:CAMPBELL, BRANDON DEAN (DDS)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:DEAN
Last Name:CAMPBELL
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 1:2463 QUAIL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-6536
Mailing Address - Country:US
Mailing Address - Phone:720-877-1390
Mailing Address - Fax:
Practice Address - Street 1:2463 QUAIL CREEK DR
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-6536
Practice Address - Country:US
Practice Address - Phone:720-877-1390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2018131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice