Organization
BETHANEY B BRENNER DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANEY B BRENNER DMD (OWNER)
(860) 673-7155
Entity
Organization
Contact information
Practice address
8 MILFORD ST, BURLINGTON, CT 06013-1715
(860) 673-7155
Mailing address
8 MILFORD ST, BURLINGTON, CT 06013-1715
(860) 673-7155
Taxonomy
Speciality
Code
Description
License number
State
1223X2210X
Orofacial Pain Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5608
LICENSE
CT
Enumeration date
12/15/2020
Last updated
12/15/2020
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