Provider Demographics
NPI:1447452503
Name:TURLEY, BRANDON LEE (DMD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:LEE
Last Name:TURLEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61154 CAMDEN PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-9566
Mailing Address - Country:US
Mailing Address - Phone:406-600-4859
Mailing Address - Fax:
Practice Address - Street 1:646 SW RIMROCK WAY
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1937
Practice Address - Country:US
Practice Address - Phone:406-600-4859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22191223G0001X
OR9078122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice