Individual
DR. GLENN A BRIEN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
122 MAIN ST, MENDENHALL, MS 39114
(601) 847-2582
Mailing address
122 MAIN ST, MENDENHALL, MS 39114
(601) 847-2582
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
159874
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00063256
—
MS
Enumeration date
11/08/2006
Last updated
07/08/2007
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