Corey J Brenner Dds Pllc | |
9000 Walnut St Box 236 Rockford MN 55373-0236 | |
(763) 477-5794 | |
(763) 477-4784 |
Full Name | Corey J Brenner Dds Pllc |
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Speciality | Clinic/center - Dental |
Location | 9000 Walnut St, Rockford, Minnesota |
Authorized Official Name and Position | Corey James Brenner (OWNER) |
Authorized Official Contact | 7634775794 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Corey J Brenner Dds Pllc 8900 Walnut St Suite 450 Box 236 Rockford MN 55373-0236 Ph: (763) 477-5794 | Corey J Brenner Dds Pllc 9000 Walnut St Box 236 Rockford MN 55373-0236 Ph: (763) 477-5794 |
NPI Number | 1689824898 |
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Provider Enumeration Date | 09/24/2008 |
Last Update Date | 06/19/2019 |
Identifier | Type | State | Issuer |
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1689824898 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | D11525 (Minnesota) | Primary |