Genna, Brian A

Genna, Brian A is an individual health care provider with primary practice located at 19 Tacoma St , Worcester MA 01605-3516. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Genna, Brian A can be contacted via phone (508) 852-1805.

Contact Information

Primary practice address
19 Tacoma St Worcester MA 01605-3516
Fax: (508) 853-8593
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DN18501 Massachusetts

Profile Details

NPI number 1093776312
LBN Legal business name Genna, Brian A
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated May 27th, 2014 - about 11 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 1093776312 NPPES
Massachusetts MEDICAID 1301071

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