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1457871188
BRANDON MECKELBERG
CHAMPAIGN, IL
NPI
1457871188
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: IL 019.031228)
Enumeration Date
2017-06-23
Last Update Date
2017-06-23
Business Address
Dr. BRANDON MECKELBERG DDS
1902 N PROSPECT AVE STE 1
CHAMPAIGN, IL 61822-1411
Phone number: 217-408-2511
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Mailing Address
Dr. BRANDON MECKELBERG DDS
N1838 N SILVER LAKE RD
WAUTOMA, WI 54982-7208
Phone number: 920-400-9009
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