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Organization
BRENNER DENTAL GROUP
Active
Organization
BRENNER DENTAL GROUP
Active
Other names
Buffalo Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COREY J BRENNER DDS (OWNER)
(612) 819-1223
Entity
Organization
Contact information
Practice address
102 MARTY DR, SUITE 3, BUFFALO, MN 55313-9305
(763) 682-2101
Mailing address
102 MARTY DR, SUITE 3, BUFFALO, MN 55313-9305
(763) 682-2101
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D11525
MN
Other
Enumeration date
03/03/2014
Last updated
03/03/2014
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