NPI 1306298104

Brandon Lee Zimmer

Practitioner Dental Assistant Fort Leonard Wood, MO

Practice location

Address: 5047 Virginia Ave Bldg 500, Fort Leonard Wood, MO 65473-9126
Phone: (573) 596-0408
Fax: (573) 596-0314

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X

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Registry record

NPI: 1306298104
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Jul 2016
Record last updated: 6 Jul 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.