Individual
DR. RICHARD CARLTON BRENKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2511 E LAMAR RD, PHOENIX, AZ 85016-1209
(602) 977-2565
(602) 938-4910
Mailing address
2511 E LAMAR RD, PHOENIX, AZ 85016-1209
(602) 977-2565
(602) 938-4910
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4802
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390493
—
AZ
Enumeration date
08/23/2005
Last updated
07/09/2007
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