# DAVID C. BRANDENBURG DDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Crestwood Comprehensive Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538623954
- **Authorized official:** KAREN ROBINSON (DENTAL ADMINISTRATOR)
- **Authorized official phone:** (301) 797-6841

## Contact information

- **Practice address:** 18709 CRESTWOOD DR, HAGERSTOWN, MD 21742-2705
- **Practice address phone:** (301) 797-6841
- **Practice address fax:** (301) 739-7965
- **Mailing address:** 18709 CRESTWOOD DR, HAGERSTOWN, MD 21742-2705
- **Mailing address phone:** (301) 797-6841
- **Mailing address fax:** (301) 739-7965

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/30/2019
- **Last updated:** 01/30/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7002381001 | — | MD |