Provider Demographics
NPI:1245443183
Name:BRANTON, LANCE ALLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:ALLEN
Last Name:BRANTON
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 1:43 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-5643
Mailing Address - Country:US
Mailing Address - Phone:610-432-2673
Mailing Address - Fax:
Practice Address - Street 1:43 S 17TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5643
Practice Address - Country:US
Practice Address - Phone:610-432-2673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023107L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice