Individual
BRENDA LEE NIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
927 RUSSELL AVE, SUITE A, GAITHERSBURG, MD 20879-6221
(301) 474-6632
Mailing address
927 RUSSELL AVE, SUITE A, GAITHERSBURG, MD 20879-6221
(301) 474-6632
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08748
MD
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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