Individual
CAROL BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3312 ELLIS WAY, LOUISVILLE, KY 40220-1944
(502) 458-9420
Mailing address
3312 ELLIS WAY, LOUISVILLE, KY 40220-1944
(502) 458-9420
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0900
KY
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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