Brandon Lee Zimmer
Dental Assistant
5047 Virginia Ave Bldg 500
Fort Leonard Wood
, Missouri 65473-9126
Brandon Lee Zimmer
Dental Assistant
5047 Virginia Ave Bldg 500
Fort Leonard Wood
, Missouri 65473-9126
(573) 596-0314
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About
Features
Specialties
- Dental Assistant
Languages spoken
- English
Location
First Address
- Brandon Lee Zimmer
- 5047 Virginia Ave Bldg 500
- Fort Leonard Wood, MO
- Zip : 65473-9126
- Fax : (573) 596-0314
- Phone : (573) 596-0408
Second Address
- Brandon Lee Zimmer
- 5047 Virginia Ave Bldg 500
- Fort Leonard Wood, MO
- Zip : 65473-9126
- Fax : (573) 596-0314
- Phone : (573) 596-0408
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 126800000X | Dental Assistant |
National Provider Identifier
| NPI | 1306298104 |
|---|---|
| Provider Name | Brandon Lee Zimmer |
| First Address | Fort Leonard Wood, MO 65473-9126 |
| Second Address | Fort Leonard Wood, MO 65473-9126 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/07/2016 |
| Last Update Date | 06/07/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.