Brenner, Charles M

Brenner, Charles M is an individual health care provider with primary practice located at 1875 Hudson Ave , Rochester NY 14617-5107. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Brenner, Charles M can be contacted via phone (585) 266-9220.

Contact Information

Primary practice address
1875 Hudson Ave Rochester NY 14617-5107
Phone: (585) 266-9220
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 030573 New York

Profile Details

NPI number 1174667794
LBN Legal business name Brenner, Charles M
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2007
Last updated Jul 8th, 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 1174667794 NPPES
New York MEDICAID 00457410
New York Other 70249

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