Individual
DR. CHARLES M BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1875 HUDSON AVE, ROCHESTER, NY 14617-5107
(585) 266-9220
Mailing address
1875 HUDSON AVE, ROCHESTER, NY 14617-5107
(585) 266-9220
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
030573
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00457410
—
NY
01
—
70249
BLUE CROSS
NY
Enumeration date
02/16/2007
Last updated
07/08/2007
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