Individual
DR. BRIAN PENTON
Active
Individual
DR. BRIAN PENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D11755
MN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
34385
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D11755
DENTIST
MN
Enumeration date
08/19/2005
Last updated
12/30/2021
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