# BRANDON D. RENSCH, D.D.S., PLLC

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

## Provider details

- **NPI number:** 1699438788
- **Authorized official:** DR. BRANDON D. RENSCH D.D.S. (OWNER)
- **Authorized official phone:** (605) 929-5467

## Contact information

- **Practice address:** 415 VICK AVE, RALEIGH, NC 27612-5025
- **Practice address phone:** (919) 787-0355
- **Mailing address:** 415 VICK AVE, RALEIGH, NC 27612-5025
- **Mailing address phone:** (605) 929-5467

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/15/2021
- **Last updated:** 11/18/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1609477405 | NA | NC |
| 01 | — | 1700041845 | NA | NC |