Individual
DR. BRENT S MCCLENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
310 W LOSEY ST, SCOTT AIR FORCE BASE, IL 62225-5250
(618) 256-3322
Mailing address
626 QUAIL RUN, O FALLON, IL 62269-3142
(618) 207-9694
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3954
AL
Other
Enumeration date
09/20/2005
Last updated
07/14/2012
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