Provider Demographics
NPI:1134308661
Name:BRAND, JANICE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:M
Last Name:BRAND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 TAMPA RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-6293
Mailing Address - Country:US
Mailing Address - Phone:727-781-6224
Mailing Address - Fax:727-787-1905
Practice Address - Street 1:3130 TAMPA RD
Practice Address - Street 2:SUITE 1
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-6293
Practice Address - Country:US
Practice Address - Phone:727-781-6224
Practice Address - Fax:727-787-1905
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00122751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice