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Individual

PETER JOSEPH BRENNY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
212 4TH ST NE, STAPLES, MN 56479
(218) 894-2755
(218) 894-3855
Mailing address
212 4TH ST NE, STAPLES, MN 56479
(218) 894-2755
(218) 894-3855

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8927
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000040915
UNITED CONCORDIA
01
81263BR
BLUE CROSS BLUE SHIELD
01
9183235
DORAL USA
Enumeration date
12/18/2006
Last updated
07/08/2007
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