Provider Demographics
NPI:1811092224
Name:TVETEN, BRANDON DEAN (DDS)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:DEAN
Last Name:TVETEN
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 1:330 KING ST
Mailing Address - Street 2:SUITE #5
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801
Mailing Address - Country:US
Mailing Address - Phone:509-662-6857
Mailing Address - Fax:509-663-8905
Practice Address - Street 1:330 KING ST
Practice Address - Street 2:SUITE 5
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801
Practice Address - Country:US
Practice Address - Phone:509-662-6857
Practice Address - Fax:509-663-8905
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA84921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice