Provider Demographics
NPI:1871615047
Name:JOE, BRANDON H (DDS)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:H
Last Name:JOE
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 1:70 N PECOS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7341
Mailing Address - Country:US
Mailing Address - Phone:702-990-8787
Mailing Address - Fax:702-990-8788
Practice Address - Street 1:70 N PECOS RD
Practice Address - Street 2:SUITE B
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7341
Practice Address - Country:US
Practice Address - Phone:702-990-8787
Practice Address - Fax:702-990-8788
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS4-251223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics