Individual
DR. MATTHEW M BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
1434 WARWICK AVE, WARWICK, RI 02888-5026
(401) 463-6350
Mailing address
1434 WARWICK AVE, WARWICK, RI 02888-5026
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN2587
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139-741
UNITED CONCORDIA
—
01
—
41-00012
UNITED HEALTHCARE
—
01
—
8037-4
BLUE CROSS
—
01
—
RG0069
BLUE CROSS MASS
—
05
—
WB01101
—
RI
Enumeration date
10/29/2007
Last updated
10/29/2007
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