Organization
DR MICHAEL BRENNAN D.M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BRENNAN (DENTIST)
(570) 344-5511
Entity
Organization
Contact information
Practice address
128 N MAIN AVE, SCRANTON, PA 18504-3327
(570) 344-5511
Mailing address
128 N MAIN AVE, SCRANTON, PA 18504-3327
(570) 344-5511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS026290-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011290720001
MEDICAL ASSISTANCE
PA
Enumeration date
03/01/2013
Last updated
03/01/2013
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