Individual
BRUCE J RENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
202 UNION ST, STE 3, TITUSVILLE, PA 16354
(814) 827-6714
(814) 827-2706
Mailing address
202 UNION ST, STE 3, TITUSVILLE, PA 16354
(814) 827-6714
(814) 827-2706
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS0201156
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005205570001
—
PA
Enumeration date
04/10/2007
Last updated
07/08/2007
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