Individual provider · NPI-1

Dr. Dominic Michael Branz, DDS

Dentist, General Practice · Missoula, MT

NPI number1861248775
StatusActive
Last updated in NPPESJun 27, 2024

Details

NPI
1861248775
Entity type
Individual (NPI-1)
Name
Dr. Dominic Michael Branz
Credential
DDS
Sex
Male
Sole proprietor
No
Enumeration date
Apr 30, 2024
Certification date
Jun 19, 2024
Last updated
Jun 27, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General PracticeDEN-DEN-LIC-28376MTYes

Practice location

2901 Brooks St
Missoula, MT 59801-7703

Phone 406-626-8616

Mailing address

2300 Mary Jane Blvd # B
Missoula, MT 59808-5889

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