Payne, Brandon C

Payne, Brandon C is an sole proprietor health care provider with primary practice located at 4728 Eagleridge Cir Ste 110 , Pueblo CO 81008-2196. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Payne, Brandon C can be contacted via phone (719) 542-4546.

Contact Information

Primary practice address
4728 Eagleridge Cir Ste 110 Pueblo CO 81008-2196
Phone: (719) 542-4546
Fax: (719) 542-4548
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 10136 Colorado
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 50000 Colorado

Profile Details

NPI number 1285772301
LBN Legal business name Payne, Brandon C
Credentials D.D.S., M.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2007
Last updated Jan 18th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285772301 NPPES
Colorado MEDICAID 33987220

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