# DR MICHAEL BRENNAN D.M.D.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013257930
- **Authorized official:** MICHAEL BRENNAN (DENTIST)
- **Authorized official phone:** (570) 344-5511

## Contact information

- **Practice address:** 128 N MAIN AVE, SCRANTON, PA 18504-3327
- **Practice address phone:** (570) 344-5511
- **Mailing address:** 128 N MAIN AVE, SCRANTON, PA 18504-3327
- **Mailing address phone:** (570) 344-5511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS026290-L | PA | Yes |

## Other

- **Enumeration date:** 03/01/2013
- **Last updated:** 03/01/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0011290720001 | MEDICAL ASSISTANCE | PA |