Provider Demographics
NPI:1730712357
Name:DENTAL TECHNOLOGY TRAINERS LLC
Entity type:Organization
Organization Name:DENTAL TECHNOLOGY TRAINERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-683-0817
Mailing Address - Street 1:489 N L ST
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-8005
Mailing Address - Country:US
Mailing Address - Phone:925-447-8344
Mailing Address - Fax:925-447-4074
Practice Address - Street 1:3 CALLE DEL ARROYO
Practice Address - Street 2:
Practice Address - City:PLACITAS
Practice Address - State:NM
Practice Address - Zip Code:87043-9407
Practice Address - Country:US
Practice Address - Phone:925-683-0817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-21
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty