Provider Demographics
NPI:1851252803
Name:BRANDON LOCKE DDS PLC
Entity type:Organization
Organization Name:BRANDON LOCKE DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:LOCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-761-3131
Mailing Address - Street 1:2523 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-3034
Mailing Address - Country:US
Mailing Address - Phone:406-761-3131
Mailing Address - Fax:406-247-0556
Practice Address - Street 1:2523 6TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-3034
Practice Address - Country:US
Practice Address - Phone:406-761-3131
Practice Address - Fax:406-247-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty