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Individual

BRENT W PENNINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
37 GATEWAY BUSINESS PARK DR, RINGGOLD, GA 30736-7395
(706) 935-2900
(706) 935-2904
Mailing address
37 GATEWAY BUSINESS PARK DR, RINGGOLD, GA 30736-7395
(706) 935-2900

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012927
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
484260991C
GA
Enumeration date
10/06/2008
Last updated
10/06/2008
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