Individual
MS. LACIE R BRENNEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
124 VALLEY VISTA DR, WOODSTOCK, VA 22664-1608
(540) 459-9333
(540) 459-1809
Mailing address
234 TISINGER ST, MOUNT JACKSON, VA 22842-9306
(757) 515-5785
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402207648
VA
Other
Enumeration date
02/05/2025
Last updated
02/05/2025
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