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Organization

BRANDON D. RENSCH, D.D.S., PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRANDON D. RENSCH D.D.S. (OWNER)
(605) 929-5467
Entity
Organization

Contact information

Practice address
415 VICK AVE, RALEIGH, NC 27612-5025
(919) 787-0355
Mailing address
415 VICK AVE, RALEIGH, NC 27612-5025
(605) 929-5467

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1609477405
NA
NC
01
1700041845
NA
NC
Enumeration date
10/15/2021
Last updated
11/18/2021
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