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Individual

DR. BRIAN ANTHONY HENNESSY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
912 GRAND AVE, SUITE 101, SAN RAFAEL, CA 94901-3563
(415) 453-3842
(415) 453-3561
Mailing address
912 GRAND AVE, SUITE 101, SAN RAFAEL, CA 94901-3563
(415) 453-3842
(415) 453-3561

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
29059
CA

Other

Enumeration date
05/09/2007
Last updated
07/08/2007
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