Provider Demographics
NPI:1356489140
Name:LANCASTER, BRANDY A (DDS)
Entity type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:A
Last Name:LANCASTER
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 1:2210 33RD ST
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360
Mailing Address - Country:US
Mailing Address - Phone:712-336-2533
Mailing Address - Fax:712-336-8103
Practice Address - Street 1:2210 33RD ST
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-7612
Practice Address - Country:US
Practice Address - Phone:712-336-2533
Practice Address - Fax:712-336-8103
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA8016122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist