Provider Demographics
NPI:1770678740
Name:DRS. ALLEY AND BRAMMER, L.C.
Entity type:Organization
Organization Name:DRS. ALLEY AND BRAMMER, L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:316-265-0856
Mailing Address - Street 1:1035 N EMPORIA ST
Mailing Address - Street 2:SUITE 175
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-2944
Mailing Address - Country:US
Mailing Address - Phone:316-265-0856
Mailing Address - Fax:316-265-0988
Practice Address - Street 1:1035 N EMPORIA ST
Practice Address - Street 2:SUITE 175
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-2944
Practice Address - Country:US
Practice Address - Phone:316-265-0856
Practice Address - Fax:316-265-0988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS58301223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS017266OtherBCBS KS
KS017266OtherBCBS KS
U02616Medicare UPIN
T77054Medicare UPIN