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Individual

DR. BRENT RANDALL NEIDENTHAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1100 HOLLY SPRINGS RD, STE. 115, HOLLY SPRINGS, NC 27540-9469
(919) 577-0017
(919) 577-6065
Mailing address
1100 HOLLY SPRINGS RD, STE. 115, HOLLY SPRINGS, NC 27540-9469
(919) 577-0017
(919) 577-6065

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7642
NC

Other

Enumeration date
07/12/2006
Last updated
07/08/2007
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