Individual
DR. BRENNA EILEEN COOLBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
12501 NORWALK BLVD, NORWALK, CA 90650-2042
(562) 929-0880
Mailing address
198 GARDEN GATE LN, IRVINE, CA 92620-0257
(919) 604-7293
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
107653
CA
1223G0001X
General Practice Dentistry
DS042581
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2019
Last updated
01/22/2023
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