Individual
DR. THERESE M DIFLORIO BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS-029126-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018523460001
—
PA
05
—
0018523460002
—
PA
01
—
02261401
CAPITAL BLUE CROSS
PA
01
—
153909
HEALTH AM/HEALTH ASSURANC
PA
01
—
9929126
DELTA DENTAL OF PA
PA
01
—
DI1315366
HIGHMARK BLUE SHIELD
PA
Enumeration date
09/21/2006
Last updated
07/12/2019
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