Provider Demographics
NPI:1316485451
Name:PIPER, BRANDY JEANETTE (RDH; LAP)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:JEANETTE
Last Name:PIPER
Suffix:
Gender:F
Credentials:RDH; LAP
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:JEANETTE
Other - Last Name:DENNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 267
Mailing Address - Street 2:34 PLEASANT VIEW LANE
Mailing Address - City:BELT
Mailing Address - State:MT
Mailing Address - Zip Code:59412-0267
Mailing Address - Country:US
Mailing Address - Phone:406-925-2856
Mailing Address - Fax:
Practice Address - Street 1:34 PLEASANT VIEW LANE
Practice Address - Street 2:
Practice Address - City:BELT
Practice Address - State:MT
Practice Address - Zip Code:59412-0267
Practice Address - Country:US
Practice Address - Phone:406-925-2856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDEN-RDH-LIC-1140124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist