# JORDAN BRENNER DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bright 32
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609289073
- **Authorized official:** DR. JORDAN MCDONALD BRENNER D.D.S. (DENTIST)
- **Authorized official phone:** (563) 271-9529

## Contact information

- **Practice address:** 1359 N 205TH ST, SUITE A, SHORELINE, WA 98133-3215
- **Practice address phone:** (206) 533-9693
- **Practice address fax:** (206) 533-9691
- **Mailing address:** 1359 N 205TH ST, SUITE A, SHORELINE, WA 98133-3215
- **Mailing address phone:** (206) 533-9693
- **Mailing address fax:** (206) 533-9691

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE60291757 | WA | Yes |

## Other

- **Enumeration date:** 06/03/2014
- **Last updated:** 06/03/2014