Provider Demographics
NPI:1497840375
Name:BRANT, ROBERT BENJAMIN (DMD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BENJAMIN
Last Name:BRANT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 4TH AVE N STE 1
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1312
Mailing Address - Country:US
Mailing Address - Phone:406-256-2121
Mailing Address - Fax:406-545-3320
Practice Address - Street 1:2525 4TH AVE N STE 1
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1312
Practice Address - Country:US
Practice Address - Phone:406-256-2121
Practice Address - Fax:406-545-3320
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD66921223G0001X
MT216271223G0001X, 332B00000X
MT212671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies