Renehan, Bradley William

Renehan, Bradley William is an sole proprietor health care provider with primary practice located at 640 Southpointe Ct #150, Colorado Springs CO 80906-3856. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Renehan, Bradley William can be contacted via phone (719) 540-6350.

Contact Information

Primary practice address
640 Southpointe Ct #150 Colorado Springs CO 80906-3856
Phone: (719) 540-6350
Fax: (719) 527-9487
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 8508 Colorado

Profile Details

NPI number 1255333720
LBN Legal business name Renehan, Bradley William
Credentials M.D.DDS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2005
Last updated Mar 21st, 2008 - about 16 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 1255333720 NPPES
Colorado MEDICAID 29054842

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