Provider Demographics
NPI:1154464196
Name:OWENSBY, BRANDI HILL (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:HILL
Last Name:OWENSBY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 TAPP WOOD RD
Mailing Address - Street 2:
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-2807
Mailing Address - Country:US
Mailing Address - Phone:706-824-0170
Mailing Address - Fax:
Practice Address - Street 1:2470 DANIELS BRIDGE RD BUILDING 200
Practice Address - Street 2:SUITE H
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-654-6287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0127541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice