Individual
DR. ALISHA DIANE BRENNEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
10201 MARTIN LUTHER KING JR HWY UNIT 240A, BOWIE, MD 20720-4003
(240) 764-5753
(240) 764-5799
Mailing address
3420 TOLEDO TER APT 320, HYATTSVILLE, MD 20782-4207
(952) 262-9328
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
16215
MD
1223P0221X
Pediatric Dentistry
Primary
16215
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800126350
—
MD
Enumeration date
02/08/2017
Last updated
10/01/2024
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