Brenke, Richard Carlton

Brenke, Richard Carlton is an individual health care provider with primary practice located at 2511 E Lamar Rd , Phoenix AZ 85016-1209. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Brenke, Richard Carlton can be contacted via phone (602) 977-2565.

Contact Information

Primary practice address
2511 E Lamar Rd Phoenix AZ 85016-1209
Phone: (602) 977-2565
Fax: (602) 938-4910
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 4802 Arizona

Profile Details

NPI number 1447243621
LBN Legal business name Brenke, Richard Carlton
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2005
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447243621 NPPES
Arizona MEDICAID 390493

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