Most Relevant Information
Provider Data
| NPI Number: | 1003654492 |
| Provider Name: | COLLIN C. BRANT DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/18/2024 |
| Last Updated: | 07/18/2024 |
Provider Practice Location
820 S DAMEN AVE # MC160
CHICAGO
IL
606123728
Practice Location Phone/Fax
| Phone: | 3125698387 |
| Fax: |
Provider Mailing Location
1451 W HURON ST APT 2
CHICAGO
IL
606426357
Provider Mailing Phone/Fax
| Phone: | 7138055488 |
| Fax: |