Individual
BRENTON L YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
139 W ROSS GROVE ROAD, SHELBY, NC 28150-3406
(704) 482-7986
(704) 480-9301
Mailing address
PO BOX 656, SHELBY, NC 28151-0656
(704) 482-7986
(704) 480-9301
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7040
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899009L
—
NC
01
—
9009L
BLUE CROSS BLUE SHIELD
NC
Enumeration date
07/10/2006
Last updated
09/11/2014
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