| Dr John G Branz | |
|
413 Pine St Wallace ID 83873-2256 | |
| (208) 752-4681 | |
| (208) 752-1259 |
| Full Name | Dr John G Branz |
|---|---|
| Speciality | Dentist |
| Location | 413 Pine St, Wallace, Idaho |
| Authorized Official Name and Position | John Guy Branz (OWNER) |
| Authorized Official Contact | 2087524681 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr John G Branz 413 Pine Street Wallace ID 83873 Ph: (208) 752-4681 | Dr John G Branz 413 Pine St Wallace ID 83873-2256 Ph: (208) 752-4681 |
| NPI Number | 1851550800 |
|---|---|
| Provider Enumeration Date | 06/05/2008 |
| Last Update Date | 06/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851550800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Idaho) | Primary |