Organization
BRENNER DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COREY J BRENNER DDS (OWNER)
(612) 819-1223
Entity
Organization
Contact information
Practice address
106 W BROADWAY ST, MONTICELLO, MN 55362-9351
(763) 295-2905
Mailing address
106 W BROADWAY ST, MONTICELLO, MN 55362-9351
(763) 295-2905
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D11525
MN
Other
Enumeration date
03/03/2014
Last updated
03/03/2014
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