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Contact Information

BRANDON GRANTHAM, DDS
1801 PATRIOT CIRCLE
COPPERAS COVE, TX76522
 Phone: 254-547-6453
 Fax: 254-547-7401
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for BRANDON GRANTHAM · (Male)

NPI # 1790849248
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 12/20/2006
Last updated 10/25/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • TX License # 22297
  • TX Other 1878704 UNITED CONCORDIA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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