Provider Demographics
NPI:1346512308
Name:BRANBERG, STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:BRANBERG
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 1:3324 MCKINNEY AVE
Mailing Address - Street 2:614
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2364
Mailing Address - Country:US
Mailing Address - Phone:310-892-0297
Mailing Address - Fax:
Practice Address - Street 1:5301 COLLEYVILLE BLVD
Practice Address - Street 2:110
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5870
Practice Address - Country:US
Practice Address - Phone:817-498-3331
Practice Address - Fax:817-479-0072
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX275651223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics