Organization
GOSHEN FAMILY DENTISTRY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY C BRENNECKE DDS (MANAGER)
(513) 722-2933
Entity
Organization
Contact information
Practice address
6782 GOSHEN RD, GOSHEN, OH 45122-9317
(513) 722-2933
(513) 722-2923
Mailing address
6782 GOSHEN RD, GOSHEN, OH 45122-9317
(513) 722-2933
(513) 722-2923
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16397
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2294539
—
OH
Enumeration date
05/31/2007
Last updated
02/13/2012
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