Provider Demographics
NPI:1851128276
Name:BRANDES, HARRISON (DMD)
Entity type:Individual
Prefix:
First Name:HARRISON
Middle Name:
Last Name:BRANDES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E STATION SQUARE DR APT 522
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-1173
Mailing Address - Country:US
Mailing Address - Phone:954-260-7142
Mailing Address - Fax:
Practice Address - Street 1:145 PAVILION LN
Practice Address - Street 2:
Practice Address - City:YOUNGWOOD
Practice Address - State:PA
Practice Address - Zip Code:15697-1814
Practice Address - Country:US
Practice Address - Phone:724-925-5972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044636122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist