Individual
BRENDEN J DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MPH
Contact information
Practice address
910 S COLUMBIA CENTER BLVD STE D, KENNEWICK, WA 99336-9560
(509) 607-1872
Mailing address
1206 N DOLARWAY RD STE 208, ELLENSBURG, WA 98926-8392
(509) 925-7600
(509) 925-9646
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60103956
WA
1223G0001X
General Practice Dentistry
DE60103956
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0255549
LABOR & INDUSTRIES
WA
05
—
5060215
—
WA
Enumeration date
08/17/2009
Last updated
08/04/2022
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