Individual
DR. BRANDON JAMES PENAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8775 AIRPORT RD, WACONIA, MN 55387-9634
(952) 239-2664
Mailing address
8775 AIRPORT RD, WACONIA, MN 55387-9634
(952) 239-2664
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13072
MN
Other
Enumeration date
05/04/2012
Last updated
06/29/2012
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